Evaluation of the osteo-inductive potential of hollow three-dimensional magnesium-strontium substitutes for the bone grafting application

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Li, Mei [State Key Laboratory for Mechanical Behavior of Materials, Xi' an Jiaotong University, Xi' an 710049 (China); Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou military command, Guangzhou 510010 (China); Yang, Xuan [Guangzhou University of Chinese Medicine, Guangzhou 510405 (China); Wang, Weidan [Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016 (China); Zhang, Yu [Department of Orthopedics, Guangdong Key Lab of Orthopaedic Technology and Implant Materials, Guangzhou General Hospital of Guangzhou military command, Guangzhou 510010 (China); Wan, Peng, E-mail: pwan@imr.ac.cn [Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016 (China); Yang, Ke [Institute of Metal Research, Chinese Academy of Sciences, Shenyang 110016 (China); Han, Yong, E-mail: yonghan@mail.xjtu.edu.cn [State Key Laboratory for Mechanical Behavior of Materials, Xi' an Jiaotong University, Xi' an 710049 (China)

2017-04-01

Regeneration of bone defects is a clinical challenge that usually necessitates bone grafting materials. Limited bone supply and donor site morbidity limited the application of autografting, and improved biomaterials are needed to match the performance of autografts. Osteoinductive materials would be the perfect candidates for achieving this task. Strontium (Sr) is known to encourage bone formation and also prevent osteoporosis. Such twin requirements have motivated researchers to develop Sr-substituted biomaterials for orthopedic applications. The present study demonstrated a new concept of developing biodegradable and hollow three-dimensional magnesium-strontium (Mg−Sr) devices for grafting with their clinical demands. The microstructure and performance of Mg−Sr devices, in vitro degradation and biological properties including in vitro cytocompatibility and osteoinductivity were investigated. The results showed that our Mg−Sr devices exhibited good cytocompatibility and osteogenic effect. To further investigate the underlying mechanisms, RT-PCR and Western Blotting assays were taken to analyze the expression level of osteogenesis-related genes and proteins, respectively. The results showed that our Mg−Sr devices could both up-regulate the genes and proteins expression of the transcription factors of Runt-related transcription factor 2 (RUNX2) and Osterix (OSX), as well as alkaline phosphatase (ALP), Osteopontin (OPN), Collagen I (COL I) and Osteocalcin (OCN) significantly. Taken together, our innovation presented in this work demonstrated that the hollow three-dimensional Mg−Sr substitutes had excellent biocompatibility and osteogenesis and could be potential candidates for bone grafting for future orthopedic applications. - Highlights: • Novel biodegradable Mg−Sr bone substitutes with the hollow and marginal design was fabricated • The Mg−Sr substitutes exhibited excellent cyto-compatibility and osteo-inductivity effects • The osteo

Design of ceramic-based cements and putties for bone graft substitution

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M Bohner

2010-07-01

Full Text Available In the last 15 years, a large number of commercial ceramic-based cements and putties have been introduced as bone graft substitutes. As a result, large efforts have been made to improve our understanding of the specific properties of these materials, such as injectability, cohesion, setting time (for cements, and in vivo properties. The aim of this manuscript is to summarize our present knowledge in the field. Instead of just looking at scientific aspects, industrial needs are also considered, including mixing and delivery, sterilization, and shelf-life.

Hydrophilicity, Viscoelastic, and Physicochemical Properties Variations in Dental Bone Grafting Substitutes

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Branko Trajkovski

2018-01-01

Full Text Available The indication-oriented Dental Bone Graft Substitutes (DBGS selection, the correct bone defects classification, and appropriate treatment planning are very crucial for obtaining successful clinical results. However, hydrophilic, viscoelastic, and physicochemical properties’ influence on the DBGS regenerative potential has poorly been studied. For that reason, we investigated the dimensional changes and molecular mobility by Dynamic Mechanical Analysis (DMA of xenograft (cerabone®, synthetic (maxresorb®, and allograft (maxgraft®, Puros® blocks in a wet and dry state. While no significant differences could be seen in dry state, cerabone® and maxresorb® blocks showed a slight height decrease in wet state, whereas both maxgraft® and Puros® had an almost identical height increase. In addition, cerabone® and maxresorb® blocks remained highly rigid and their damping behaviour was not influenced by the water. On the other hand, both maxgraft® and Puros® had a strong increase in their molecular mobility with different damping behaviour profiles during the wet state. A high-speed microscopical imaging system was used to analyze the hydrophilicity in several naturally derived (cerabone®, Bio-Oss®, NuOss®, SIC® nature graft and synthetic DBGS granules (maxresorb®, BoneCeramic®, NanoBone®, Ceros®. The highest level of hydrophilicity was detected in cerabone® and maxresorb®, while Bio-Oss® and BoneCeramic® had the lowest level of hydrophilicity among both naturally derived and synthetic DBGS groups. Deviations among the DBGS were also addressed via physicochemical differences recorded by Micro Computed Tomography, Scanning Electron Microscopy, Fourier Transform Infrared Spectroscopy, X-ray powder Diffractometry, and Thermogravimetric Analysis. Such DBGS variations could influence the volume stability at the grafting site, handling as well as the speed of vascularization and bone regeneration. Therefore, this study initiates a new

Radiographic Comparison of Bovine Bone Substitute Alone versus Bovine Bone Substitute and Simvastatin for Human Maxillary Sinus Augmentation

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Amir Ali Reza Rasouli Ghahroudi

2018-01-01

Full Text Available Objectives: The aim of this study was to compare the efficacy of bovine bone substitute (Compact Bone B. ® alone versus bovine bone substitute and simvastatin for human maxillary sinus augmentation.Materials and Methods: This study was conducted on 16 sinuses in eight patients. Radiographic assessments were done preoperatively (T0, immediately (T1 and at nine months after sinus grafting (T2. Alveolar bone height and density were assessed on cone beam computed tomography (CBCT scans using Planmeca Romexis™ Imaging Software 2.2.Results: The change in alveolar bone height and density between T0, T1 and T2 was significant in both groups. Alveolar bone height (h0, h1, h2 and vertical height of the grafted bone (g1, g2 in three lines (anterior, middle and posterior were not significantly different between groups. The grafted bone height shrinkage (% in the anterior, middle and posterior limits of the augmented area were not significantly different between groups. The existing alveolar and grafted bone density increased significantly in both groups between T1 and T2, except for the existing alveolar bone density in the control group. There were no statistically significant differences between the alveolar bone density values obtained in TI and T2 between groups, except for the existing alveolar bone density at T1.Conclusions: This study did not show any significant positive effect for simvastatin in maxillary sinus augmentation based on radiographic examination.

Biologic and clinical aspects of integration of different bone substitutes in oral surgery: a literature review.

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Zizzari, Vincenzo Luca; Zara, Susi; Tetè, Giulia; Vinci, Raffaele; Gherlone, Enrico; Cataldi, Amelia

2016-10-01

Many bone substitutes have been proposed for bone regeneration, and researchers have focused on the interactions occurring between grafts and host tissue, as the biologic response of host tissue is related to the origin of the biomaterial. Bone substitutes used in oral and maxillofacial surgery could be categorized according to their biologic origin and source as autologous bone graft when obtained from the same individual receiving the graft; homologous bone graft, or allograft, when harvested from an individual other than the one receiving the graft; animal-derived heterologous bone graft, or xenograft, when derived from a species other than human; and alloplastic graft, made of bone substitute of synthetic origin. The aim of this review is to describe the most commonly used bone substitutes, according to their origin, and to focus on the biologic events that ultimately lead to the integration of a biomaterial with the host tissue. Copyright © 2016 Elsevier Inc. All rights reserved.

Alternatives to Autologous Bone Graft in Alveolar Cleft Reconstruction: The State of Alveolar Tissue Engineering.

Science.gov (United States)

Liang, Fan; Leland, Hyuma; Jedrzejewski, Breanna; Auslander, Allyn; Maniskas, Seija; Swanson, Jordan; Urata, Mark; Hammoudeh, Jeffrey; Magee, William

2018-05-01

Alveolar cleft reconstruction has historically relied on autologous iliac crest bone grafting (ICBG), but donor site morbidity, pain, and prolonged hospitalization have prompted the search for bone graft substitutes. The authors evaluated bone graft substitutes with the highest levels of evidence, and highlight the products that show promise in alveolar cleft repair and in maxillary augmentation. This comprehensive review guides the craniofacial surgeon toward safe and informed utilization of biomaterials in the alveolar cleft.A literature search was performed to identify in vitro human studies that fulfilled the following criteria: Level I or Level II of evidence, ≥30 subjects, and a direct comparison between a autologous bone graft and a bone graft substitute. A second literature search was performed that captured all studies, regardless of level of evidence, which evaluated bone graft substitutes for alveolar cleft repair or alveolar augmentation for dental implants. Adverse events for each of these products were tabulated as well.Sixteen studies featuring 6 bone graft substitutes: hydroxyapatite, demineralized bone matrix (DBM), β-tricalcium phosphate (TCP), calcium phosphate, recombinant human bone morphogenic protein-2 (rhBMP-2), and rhBMP7 fit the inclusion criteria for the first search. Through our second search, the authors found that DBM, TCP, rhBMP-2, and rhBMP7 have been studied most extensively in the alveolar cleft literature, though frequently in studies using less rigorous methodology (Level III evidence or below). rhBMP-2 was the best studied and showed comparable efficacy to ICBG in terms of volume of bone regeneration, bone density, and capacity to accommodate tooth eruption within the graft site. Pricing for products ranged from $290 to $3110 per 5 mL.The balance between innovation and safety is a complex process requiring constant vigilance and evaluation. Here, the authors profile several bone graft substitutes that demonstrate the most

In vivo analysis of biocompatibility and vascularization of the synthetic bone grafting substitute NanoBone.

Science.gov (United States)

Abshagen, K; Schrodi, I; Gerber, T; Vollmar, B

2009-11-01

One of the major challenges in the application of bone substitutes is adequate vascularization and biocompatibility of the implant. Thus, the temporal course of neovascularization and the microvascular inflammatory response of implants of NanoBone (fully synthetic nanocrystalline bone grafting material) were studied in vivo by using the mouse dorsal skinfold chamber model. Angiogenesis, microhemodynamics, and leukocyte-endothelial cell interaction were analyzed repetitively after implantation in the center and in the border zone of the implant up to 15 days. Both NanoBone granules and plates exhibited high biocompatibility comparable to that of cancellous bone, as indicated by a lack of venular leukocyte activation after implantation. In both synthetic NanoBone groups, signs of angiogenesis could be observed even at day 5 after implantation, whereas granules showed higher functional vessel density compared with NanoBone plates. The angiogenic response of the cancellous bone was markedly accelerated in the center of the implant tissue. Histologically, implant tissue showed an ingrowth of vascularized fibrous tissue into the material combined with an increased number of foreign-body giant cells. In conclusion, NanoBone, particularly in granular form, showed high biocompatibility and high angiogenic response, thus improving the healing of bone defects. Our results underline that, beside the composition and nanostructure, the macrostructure is also of importance for the incorporation of the biomaterial by the host tissue. (c) 2008 Wiley Periodicals, Inc.

No effect of Osteoset, a bone graft substitute, on bone healing in humans: a prospective randomized double-blind study

DEFF Research Database (Denmark)

Petruskevicius, Juozas; Nielsen, Mette Strange; Kaalund, Søren

2002-01-01

We studied the effects of a newly marketed bone substitute, Osteoset, on bone healing in a tibial defect in humans. 20 patients undergoing an ACL (anterior cruciate ligament) reconstruction with bone-patella tendon-bone graft were block-randomized into 2 groups of 10 each. In the treatment group......, the tibial defect was filled manually with Osteoset pellets, in the control group the defect was left empty. CTs of the defect were taken on the first day after the operation, 6 weeks, 3 and 6 months postoperatively. We found about the same amount of bone in the defect in the Osteoset and control groups...... after 6 weeks, 3, and 6 months. In the control group, but not in the Osteoset group, the bone volume increased from 6 weeks to 3 months. The Osteoset pellets were almost resorbed after 6 weeks....

Ordinary and Activated Bone Grafts: Applied Classification and the Main Features

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R. V. Deev

2015-01-01

Full Text Available Bone grafts are medical devices that are in high demand in clinical practice for substitution of bone defects and recovery of atrophic bone regions. Based on the analysis of the modern groups of bone grafts, the particularities of their composition, the mechanisms of their biological effects, and their therapeutic indications, applicable classification was proposed that separates the bone substitutes into “ordinary” and “activated.” The main differential criterion is the presence of biologically active components in the material that are standardized by qualitative and quantitative parameters: growth factors, cells, or gene constructions encoding growth factors. The pronounced osteoinductive and (or osteogenic properties of activated osteoplastic materials allow drawing upon their efficacy in the substitution of large bone defects.

Bone graft extenders and substitutes in the thoracolumbar spine.

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Arner, Justin W; Daffner, Scott D

2012-05-01

Autologous iliac crest bone graft remains the gold standard for lumbar fusion. The potential for complications has led to the development of alternative bone graft materials and enhancers, including autologous growth factors, demineralized bone matrix products, osteoinductive agents, and ceramic products. The current literature centers mainly on preclinical studies, which, further complicating the situation, evaluate these products in different clinical scenarios or surgical techniques. Autologous growth factors and demineralized bone matrix products have had promising results in preclinical studies, but few strong clinical studies have been conducted. Ceramic extenders were evaluated with other substances and had good but often inconsistent results. Bone morphogenetic proteins have been extensively studied and may have benefits as osteoinductive agents. Category comparisons are difficult to make, and there are differences even between products within the same category. The surgeon must be knowledgeable about products and their advantages, disadvantages, indications, contraindications, and possible applications so that they can make the best choice for each patient.

The fate of allogenic radiation sterilized bone grafts controlled by the electron spin resonance spectrometry

International Nuclear Information System (INIS)

Ostrowski, K.; Dziedzic-Goclawska, A.

1981-01-01

The normal fate of bone grafts is their resorption and substitution by the own host's bone tissue. This phenomenon described as creeping substitution process was controlled using biopsies from the grafted region in allogenic experimental system. Electron spin resonance (ESR) spectrometry was used for independent evaluation of resorption and substitution processes. The measurements were based on the process of induction in the hydroxyapatite (HA) crystals of bone mineral of stable paramagnetic centers which can be detected by ESR spectrometry. The loss of total amount of spins connected with the paramagnetic centers expressed in percent describes the kinetics of resorption. The changes in the concentration of spins due to the ''dilution'' of spins implanted with the graft by the nonirradiated ingrowing host's own bone describe the kinetics of the substitution process. Allogenic bone of calvaria was grafted orthotopically into rabbits after lyophilization and radiation sterilization with a dose of 3.5 Mrads. The process of graft's rebuilding was evaluated using the described ESR method. The application of the described technique in the human clinic is possible. (author)

Preliminary investigation of novel bone graft substitutes based on strontium-calcium-zinc-silicate glasses.

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Boyd, D; Carroll, G; Towler, M R; Freeman, C; Farthing, P; Brook, I M

2009-01-01

Bone graft procedures typically require surgeons to harvest bone from a second site on a given patient (Autograft) before repairing a bone defect. However, this results in increased surgical time, excessive blood loss and a significant increase in pain. In this context a synthetic bone graft with excellent histocompatibility, built in antibacterial efficacy and the ability to regenerate healthy tissue in place of diseased tissue would be a significant step forward relative to current state of the art philosophies. We developed a range of calcium-strontium-zinc-silicate glass based bone grafts and characterised their structure and physical properties, then evaluated their in vitro cytotoxicity and in vivo biocompatibility using standardised models from the literature. A graft (designated BT109) of composition 0.28SrO/0.32ZnO/0.40 SiO(2) (mol fraction) was the best performing formulation in vitro shown to induce extremely mild cytopathic effects (cell viability up to 95%) in comparison with the commercially available bone graft Novabone (cell viability of up to 72%). Supplementary to this, the grafts were examined using the standard rat femur healing model on healthy Wister rats. All grafts were shown to be equally well tolerated in bone tissue and new bone was seen in close apposition to implanted particles with no evidence of an inflammatory response within bone. Complimentary to this BT109 was implanted into the femurs of ovariectomized rats to monitor the response of osteoporotic tissue to the bone grafts. The results from this experiment indicate that the novel grafts perform equally well in osteoporotic tissue as in healthy tissue, which is encouraging given that bone response to implants is usually diminished in ovariectomized rats. In conclusion these materials exhibit significant potential as synthetic bone grafts to warrant further investigation and optimisation.

Advances in Osteobiologic Materials for Bone Substitutes.

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Hasan, Anwarul; Byambaa, Batzaya; Morshed, Mahboob; Cheikh, Mohammad Ibrahim; Shakoor, Rana Abdul; Mustafy, Tanvir; Marei, Hany

2018-04-27

A significant challenge in the current orthopedics is the development of suitable osteobiologic materials that can replace the conventional allografts, autografts and xenografts, and thereby serve as implant materials as bone substitutes for bone repair or remodeling. The complex biology behind the nano-microstructure of bones and their repair mechanisms, which involve various types of chemical and biomechanical signaling amongst different cells, has set strong requirements for biomaterials to be used in bone tissue engineering. This review presents an overview of various types of osteobiologic materials to facilitate the formation of the functional bone tissue and healing of the bone, covering metallic, ceramic, polymeric and cell-based graft substitutes, as well as some biomolecular strategies including stem cells, extracellular matrices, growth factors and gene therapies. Advantages and disadvantages of each type, particularly from the perspective of osteoinductive and osteoconductive capabilities, are discussed. Although the numerous challenges of bone regeneration in tissue engineering and regenerative medicine are yet to be entirely addressed, further advancements in osteobiologic materials will pave the way towards engineering fully functional bone replacement grafts. This article is protected by copyright. All rights reserved.

Comparison of three calcium phosphate bone graft substitutes from biomechanical, histological, and crystallographic perspectives using a rat posterolateral lumbar fusion model

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Hu, Ming-Hsien [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Department of Orthopedics, Show-Chwan Memorial Hospital, Changhua 50544, Taiwan (China); Department of Orthopedic Surgery, Faculty of Medicine, National Yang-Ming University, Taipei 112, Taiwan (China); Lee, Pei-Yuan [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Department of Orthopedics, Show-Chwan Memorial Hospital, Changhua 50544, Taiwan (China); Chen, Wen-Cheng, E-mail: wincheng0925@yahoo.com.tw [Department of Fiber and Composite Materials, College of Engineering, Feng Chia University, Taichung 40724, Taiwan (China); Hu, Jin-Jia, E-mail: jjhu@mail.ncku.edu.tw [Department of Biomedical Engineering, National Cheng Kung University, Tainan 701, Taiwan (China); Medical Device Innovation Center, National Cheng Kung University, Tainan 701, Taiwan (China)

2014-12-01

This study evaluated the effectiveness of three calcium phosphate bone graft substitutes with different chemical compositions on spinal fusion using a rat posterolateral lumbar fusion model. Specifically, two recently developed non-dispersive tetracalcium phosphate/dicalcium phosphate anhydrous-based calcium phosphate cements (CPCs), namely a CPC consisting of equimolar amounts of the two compounds (nd-CPC) and a CPC consisting of a two-fold greater amount of dicalcium phosphate anhydrous (DCP-rich CPC), were compared with a commercial calcium phosphate bone graft (c-CPG) consisting of hydroxyapatite (60%) and β-tricalcium phosphate (40%). Single-level posterolateral lumbar fusion was performed at the L4–L5 vertebrae in fifteen adult rats (n = 5 for each group). Spinal fusion was evaluated with radiographs, manual palpation, mechanical testing, micro-CT, and histology 8 weeks post-surgery. In particular, the crystallographic phases in the three substitutes were identified before and 8 weeks after their implantation. Manual palpation revealed stable constructs in nearly all of the spine specimens. The stiffness and bending load of fused spines in the two CPC groups were comparable to those in the c-CPG group. The radiographs specifically revealed implant resorption and bone remodeling in the DCP-rich CPC group. Analysis of 3D micro-CT images revealed that the bone volume ratio in the DCP-rich CPC group was significantly greater than those in the nd-CPC and c-CPG groups. Histology showed that the DCP-rich CPC group exhibited the highest degree of bone regeneration and osseointegration. Notably, DCP-rich CPC led to a pronounced phase transformation, generating the greatest amount of poorly crystalline apatite among the three groups, which together with adequate resorption may explain the aforementioned positive findings. We therefore conclude that of the bone graft substitutes considered, DCP-rich CPC has the greatest potential to be used in spinal fusion

A Bone Sample Containing a Bone Graft Substitute Analyzed by Correlating Density Information Obtained by X-ray Micro Tomography with Compositional Information Obtained by Raman Microscopy

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Johann Charwat-Pessler

2015-06-01

Full Text Available The ability of bone graft substitutes to promote new bone formation has been increasingly used in the medical field to repair skeletal defects or to replace missing bone in a broad range of applications in dentistry and orthopedics. A common way to assess such materials is via micro computed tomography (µ-CT, through the density information content provided by the absorption of X-rays. Information on the chemical composition of a material can be obtained via Raman spectroscopy. By investigating a bone sample from miniature pigs containing the bone graft substitute Bio Oss®, we pursued the target of assessing to what extent the density information gained by µ-CT imaging matches the chemical information content provided by Raman spectroscopic imaging. Raman images and Raman correlation maps of the investigated sample were used in order to generate a Raman based segmented image by means of an agglomerative, hierarchical cluster analysis. The resulting segments, showing chemically related areas, were subsequently compared with the µ-CT image by means of a one-way ANOVA. We found out that to a certain extent typical gray-level values (and the related histograms in the µ-CT image can be reliably related to specific segments within the image resulting from the cluster analysis.

Bone grafting: An overview

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D. O. Joshi

2010-08-01

Full Text Available Bone grafting is the process by which bone is transferred from a source (donor to site (recipient. Due to trauma from accidents by speedy vehicles, falling down from height or gunshot injury particularly in human being, acquired or developmental diseases like rickets, congenital defects like abnormal bone development, wearing out because of age and overuse; lead to bone loss and to replace the loss we need the bone grafting. Osteogenesis, osteoinduction, osteoconduction, mechanical supports are the four basic mechanisms of bone graft. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. An ideal bone graft material is biologically inert, source of osteogenic, act as a mechanical support, readily available, easily adaptable in terms of size, shape, length and replaced by the host bone. Except blood, bone is grafted with greater frequency. Bone graft indicated for variety of orthopedic abnormalities, comminuted fractures, delayed unions, non-unions, arthrodesis and osteomyelitis. Bone graft can be harvested from the iliac crest, proximal tibia, proximal humerus, proximal femur, ribs and sternum. By adopting different procedure of graft preservation its antigenicity can be minimized. The concept of bone banking for obtaining bone grafts and implants is very useful for clinical application. Absolute stability require for successful incorporation. Ideal bone graft must possess osteogenic, osteoinductive and osteocon-ductive properties. Cancellous bone graft is superior to cortical bone graft. Usually autologous cancellous bone graft are used as fresh grafts where as allografts are employed as an alloimplant. None of the available type of bone grafts possesses all these properties therefore, a single type of graft cannot be recomm-ended for all types of orthopedic abnormalities. Bone grafts and implants can be selected as per clinical problems, the equipments available and preference of

Bone Graft Alternatives

Science.gov (United States)

... Spine Treatment Spondylolisthesis BLOG FIND A SPECIALIST Treatments Bone Graft Alternatives Patient Education Committee Patient Education Committee ... procedure such as spinal fusion. What Types of Bone Grafts are There? Bone grafts that are transplanted ...

Histological comparison of autograft, allograft-DBM, xenograft, and synthetic grafts in a trabecular bone defect: an experimental study in rabbits.

Science.gov (United States)

Athanasiou, Vasilis T; Papachristou, Dionysios J; Panagopoulos, Andreas; Saridis, Alkis; Scopa, Chrisoula D; Megas, Panagiotis

2010-01-01

Different types of bone-graft substitutes have been developed and are on the market worldwide to eliminate the drawbacks of autogenous grafting. This experimental animal study was undertaken to evaluate the different histological properties of various bone graft substitutes utilized in this hospital. Ninety New Zealand white rabbits were divided into six groups of 15 animals. Under general anesthesia, a 4.5 mm-wide hole was drilled into both the lateral femoral condyles of each rabbit, for a total of 180 condyles for analysis. The bone defects were filled with various grafts, these being 1) autograft, 2) DBM crunch allograft (Grafton), 3) bovine cancellous bone xenograft (Lubboc), 4) calcium phosphate hydroxyapatite substitute (Ceraform), 5) calcium sulfate substitute (Osteoset), and 6) no filling (control). The animals were sacrificed at 1, 3, and 6 months after implantation and tissue samples from the implanted areas were processed for histological evaluation. A histological grading scale was designed to determine the different histological parameters of bone healing. The highest histological grades were achieved with the use of cancellous bone autograft. Bovine xenograft (Lubboc) was the second best in the histological scale grading. The other substitutes (Grafton, Ceraform, Osteoset) had similar scores but were inferior to both allograft and xenograft. Bovine xenograft showed better biological response than the other bone graft substitutes; however, more clinical studies are necessary to determine its overall effectiveness.

Efficacy of novel synthetic bone substitutes in the reconstruction of large segmental bone defects in sheep tibiae

International Nuclear Information System (INIS)

Li, Jiao Jiao; Roohani-Esfahani, Seyed-Iman; Dunstan, Colin R; Quach, Terrence; Zreiqat, Hala; Steck, Roland; Saifzadeh, Siamak; Pivonka, Peter

2016-01-01

The treatment of large bone defects, particularly those with segmental bone loss, remains a significant clinical challenge as current approaches involving surgery or bone grafting often do not yield satisfactory long-term outcomes. This study reports the evaluation of novel ceramic scaffolds applied as bone graft substitutes in a clinically relevant in vivo model. Baghdadite scaffolds, unmodified or modified with a polycaprolactone coating containing bioactive glass nanoparticles, were implanted into critical-sized segmental bone defects in sheep tibiae for 26 weeks. Radiographic, biomechanical, μ-CT and histological analyses showed that both unmodified and modified baghdadite scaffolds were able to withstand physiological loads at the defect site, and induced substantial bone formation in the absence of supplementation with cells or growth factors. Notably, all samples showed significant bridging of the critical-sized defect (average 80%) with evidence of bone infiltration and remodelling within the scaffold implant. The unmodified and modified baghdadite scaffolds achieved similar outcomes of defect repair, although the latter may have an initial mechanical advantage due to the nanocomposite coating. The baghdadite scaffolds evaluated in this study hold potential for use as purely synthetic bone graft substitutes in the treatment of large bone defects while circumventing the drawbacks of autografts and allografts. (paper)

Impact of bone graft harvesting techniques on bone formation and graft resorption

DEFF Research Database (Denmark)

Saulacic, Nikola; Bosshardt, Dieter D; Jensen, Simon S

2015-01-01

BACKGROUND: Harvesting techniques can affect cellular parameters of autogenous bone grafts in vitro. Whether these differences translate to in vivo bone formation, however, remains unknown. OBJECTIVE: The purpose of this study was to assess the impact of different harvesting techniques on bone fo......: Transplantation of autogenous bone particles harvested with four techniques in the present model resulted in moderate differences in terms of bone formation and graft resorption.......BACKGROUND: Harvesting techniques can affect cellular parameters of autogenous bone grafts in vitro. Whether these differences translate to in vivo bone formation, however, remains unknown. OBJECTIVE: The purpose of this study was to assess the impact of different harvesting techniques on bone...... formation and graft resorption in vivo. MATERIAL AND METHODS: Four harvesting techniques were used: (i) corticocancellous blocks particulated by a bone mill; (ii) bone scraper; (iii) piezosurgery; and (iv) bone slurry collected from a filter device upon drilling. The grafts were placed into bone defects...

Bone grafts in dentistry

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Prasanna Kumar

2013-01-01

Full Text Available Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation.

Comparative Efficacies of Collagen-Based 3D Printed PCL/PLGA/?-TCP Composite Block Bone Grafts and Biphasic Calcium Phosphate Bone Substitute for Bone Regeneration

OpenAIRE

Hwang, Kyoung-Sub; Choi, Jae-Won; Kim, Jae-Hun; Chung, Ho Yun; Jin, Songwan; Shim, Jin-Hyung; Yun, Won-Soo; Jeong, Chang-Mo; Huh, Jung-Bo

2017-01-01

The purpose of this study was to compare bone regeneration and space maintaining ability of three-dimensional (3D) printed bone grafts with conventional biphasic calcium phosphate (BCP). After mixing polycaprolactone (PCL), poly (lactic-co-glycolic acid) (PLGA), and ?-tricalcium phosphate (?-TCP) in a 4:4:2 ratio, PCL/PLGA/?-TCP particulate bone grafts were fabricated using 3D printing technology. Fabricated particulate bone grafts were mixed with atelocollagen to produce collagen-based PCL/P...

Ceramic and non-ceramic hydroxyapatite as a bone graft material: a brief review.

Science.gov (United States)

Dutta, S R; Passi, D; Singh, P; Bhuibhar, A

2015-03-01

Treatment of dental, craniofacial and orthopedic defects with bone graft substitutes has shown promising result achieving almost complete bone regeneration depending on product resorption similar to human bone's physicochemical and crystallographic characteristics. Among these, non-ceramic and ceramic hydroxyapatite being the main inorganic salt of bone is the most studied calcium phosphate material in clinical practices ever since 1970s and non-ceramic since 1985. Its "chemical similarity" with the mineralized phase of biologic bone makes it unique. Hydroxyapatite as an excellent carrier of osteoinductive growth factors and osteogenic cell populations is also useful as drug delivery vehicle regardless of its density. Porous ceramic and non-ceramic hydroxyapatite is osteoconductive, biocompatible and very inert. The need for bone graft material keeps on increasing with increased age of the population and the increased conditions of trauma. Recent advances in genetic engineering and doping techniques have made it possible to use non-ceramic hydroxyapatite in larger non-ceramic crystals and cluster forms as a successful bone graft substitute to treat various types of bone defects. In this paper we have mentioned some recently studied properties of hydroxyapatite and its various uses through a brief review of the literatures available to date.

Matrix change of bone grafting substitute after implantation into guinea pig bulla.

Science.gov (United States)

Punke, Ch; Zehlicke, T; Just, T; Holzhüter, G; Gerber, T; Pau, H W

2012-05-01

Many different surgical techniques have been developed to remove open mastoid cavities. In addition to autologous materials, alloplastic substances have been used. A very slow absorption of these materials and extrusion reactions have been reported. We investigated a newly developed, highly porous bone grafting material to eliminate open mastoid cavities, in an animal model. To characterise the transformation process, the early tissue reactions were studied in relation to the matrix transformation of the bone material. NanoBone (NB), a highly porous bone grafting material based on calcium phosphate and silica, was filled into the open bullae from 20 guinea pigs. The bullae were examined histologically. Energy dispersive X-ray spectroscopy (EDX) was used to investigate the change in the elemental composition at different sampling times. The surface topography of the sections was examined by electron microscopy. After 1 week, periodic acid-Schiffs (PAS) staining demonstrated accumulation of glycogen and proteins, particularly in the border area of the NB particles. After 2 weeks, the particles were evenly coloured after PAS staining. EDX analysis showed a rapid absorption of the silica in the bone grafting material. NanoBone showed a rapid matrix change after implantation in the bullae of guinea pigs. The absorption of the silica matrix and replacement by PAS-positive substances like glycoproteins and mucopolysaccharides seems to play a decisive role in the degradation processes of NB. This is associated with the good osteoinductive properties of the material.

Bone graft revascularization strategies

NARCIS (Netherlands)

Willems, W.F.

2014-01-01

Reconstruction of avascular necrotic bone by pedicled bone grafting is a well-known treatment with little basic research supporting its application. A new canine model was used to simulate carpal bone avascular necrosis. Pedicled bone grafting proved to increase bone remodeling and bone blood flow,

Liquid nitrogen-treated autogenous dentin as bone substitute: an experimental study in a rabbit model.

Science.gov (United States)

Atiya, Basim K; Shanmuhasuntharam, Palasuntharam; Huat, Siar; Abdulrazzak, Shurooq; Oon, Ha

2014-01-01

Different forms of dentin, including untreated, undemineralized, demineralized, boiled, or mixed with other materials, have been evaluated for efficacy as bone substitutes. However, the effects of application of liquid nitrogen-treated dentin for bone grafting remain unknown. The objective of this study was to chronologically evaluate bone healing following grafting with liquid nitrogen-treated dentin in a rabbit model. Autogenous dentin treated with liquid nitrogen at -196°C for 20 minutes was used. In 16 New Zealand White rabbits, a bone defect (5 mm in diameter) was created in each femur and randomly grafted with either autogenous dentin (experimental group) or autogenous bone grafts (positive control). In another four rabbits (negative control), a similar defect in each femur was left empty. The rabbits were sacrificed at 2, 4, 8, and 12 weeks. Explants of grafted sites were harvested for histologic and histomorphometric analysis. At 2 and 4 weeks in both the experimental and positive control groups, accelerated formation of new bone was observed, which was undergoing remodeling at 8 and 12 weeks. The mean new bone score was higher in the experimental than in the negative control groups, but this was not statistically significant. The present results demonstrated that liquid nitrogen-treated autogenous dentin has both osteoconductive and osteoinductive properties and therefore has potential as a bone substitute.

3D printing of octacalcium phosphate bone substitutes

Directory of Open Access Journals (Sweden)

Vladimir S. Komlev

2015-06-01

Full Text Available Biocompatible calcium phosphate ceramic grafts are able of supporting new bone formation in appropriate environment. The major limitation of these materials usage for medical implants is the absence of accessible methods for their patient-specific fabrication. 3D printing methodology is an excellent approach to overcome the limitation supporting effective and fast fabrication of individual complex bone substitutes. Here we proposed a relatively simple route for 3D printing of octacalcium phosphates in complexly shaped structures by the combination of inkjet printing with post-treatment methodology. The printed octacalcium phosphate blocks were further implanted in the developed cranial bone defect followed by histological evaluation. The obtained result confirmed the potential of the developed octacalcium phosphates bone substitutes, which allowed 2.5-time reducing of defect’s diameter at 6.5 months in a region where native bone repair is extremely inefficient.

Bone graft viability evaluated by three phase bone scan

International Nuclear Information System (INIS)

Ljiljana Jaukovic Rajko Spaic; Marijan Novakovic; Srbislav Stosic

2004-01-01

Bone defects resulting war injury can be replaced by microvascular bone grafts from fibula. Aim: The aim of this study was to assess the value of three phase (3P) bone scintigraphy in the early detection of the bone graft complications. Method: 3P bone scans were performed in four patients (two after mandible reconstruction with micro vascular fibular bone grafts, one after fibular transplantation for ulnar and one with humeral reconstruction). First dynamic phase scan was performed immediately after iv injection of 740 MBq Tc- 99m DPD, acquiring 15 two seconds duration frames. Second, early static scan was performed during next 300 seconds, and third, delayed scan three hours later. All scans were obtained under the bone graft region. The scans were evaluated using ROI under graft region and the corresponding contra lateral area. Blood flow in graft region was determined using first phase scan, and tracer uptake in the same region was determined using second and third phase scans. Results: in all patients blood flow in graft region was particularly normal. Tracer uptake in one of two patients with mandible reconstruction was diffusely increased in graft, strongly suggesting infection; In the other patient delayed scan showed no tracer uptake in graft center .Both patients with ulnar and humeral reconstruction showed only slightly decreased tracer uptake in bone grafts. 3 phase bone scintigraphy may play a role in the evaluation of bone graft viability by predicting the infection and necrosis. (authors)

Local bone graft harvesting and volumes in posterolateral lumbar fusion: a technical report.

Science.gov (United States)

Carragee, Eugene J; Comer, Garet C; Smith, Micah W

2011-06-01

In lumbar surgery, local bone graft is often harvested and used in posterolateral fusion procedures. The volume of local bone graft available for posterolateral fusion has not been determined in North American patients. Some authors have described this as minimal, but others have suggested the volume was sufficient to be reliably used as a stand-alone bone graft substitute for single-level fusion. To describe the technique used and determine the volume of local bone graft available in a cohort of patients undergoing single-level primary posterolateral fusion by the authors harvesting technique. Technical description and cohort report. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes. Local bone graft volume. Consecutive patients undergoing lumbar posterolateral fusion with or without instrumentation for degenerative processes of were studied. Local bone graft was harvested by a standard method in each patient and the volume measured by a standard procedure. Twenty-five patients were studied, and of these 11 (44%) had a previous decompression. The mean volume of local bone graft harvested was measured to be 25 cc (range, 12-36 cc). Local bone graft was augmented by iliac crest bone in six of 25 patients (24%) if the posterolateral fusion bed was not well packed with local bone alone. There was a trend to greater local bone graft volumes in men and in patients without previous decompression. Large volumes of local bone can be harvested during posterolateral lumbar fusion surgery. Even in patients with previous decompression the volume harvested is similar to that reported harvested from the posterior iliac crest for single-level fusion. Copyright © 2011 Elsevier Inc. All rights reserved.

Bone graft materials in fixation of orthopaedic implants in sheep

DEFF Research Database (Denmark)

Babiker, Hassan

2013-01-01

Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...

The biodegradation of hydroxyapatite bone graft substitutes in vivo.

Science.gov (United States)

Rumpel, E; Wolf, E; Kauschke, E; Bienengräber, V; Bayerlein, T; Gedrange, T; Proff, P

2006-02-01

Hydroxyapatite (HA) ceramics are widely used for bone reconstruction. They are osteoconductive and serve as structural scaffolds for the deposition of new bone. Generally, scaffold materials should be degradable as they affect the mechanical properties of the reconstructed bone negatively. Degradation by osteoclasts during the bone remodelling process is desirable but often does not take place. In the current study we analysed by light microscopy the degradation of two granular HA implants in critically sized defects in the mandibula of Goettingen mini-pigs five weeks after implantation. Bio-Oss consists of sintered bovine bone and NanoBone is a synthetic HA produced in a sol-gel process in the presence of SiO2. We found that both biomaterials were degraded by osteoclasts with ruffled borders and acid phosphatase activity. The osteoclasts created resorption lacunae and resorptive trails and contained mineral particles. Frequently, resorption surfaces were in direct contact with bone formative surfaces on one granule. Granules, especially of NanoBone, were also covered by osteoclasts if located in vascularised connective tissue distant from bone tissue. However, this usually occurred without the creation of resorption lacunae. The former defect margins consisted of newly formed bone often without remnants of bone substitutes. Our results show that the degradation of both biomaterials corresponds to the natural bone degradation processes and suggest the possibility of complete resorption during bone remodelling.

Bone formation in cranial, mandibular, tibial and iliac bone grafts in rats

DEFF Research Database (Denmark)

Solheim, E; Pinholt, E M; Talsnes, O

1995-01-01

Several studies have suggested that grafts from membranous derived bone (e.g., calvarial grafts) retain their volume better than those from endochondral derived bone (e.g., iliac bone grafts). Increased osteogenesis in grafts of the former type has been offered as the explanation. However, simple...... volume measurements of the recovered grafts do not differentiate between viable and dead bone. We studied fresh syngeneic full-thickness bone grafts from calvaria, mandibula, tibia diaphysis, and iliac bone implanted in the back muscles of young Lewis rats. Bone formation in grafts recovered 3 weeks...... that the anatomical area of harvest is important regarding new bone formation in syngeneic bone grafts. However, the results do not support the contention that better maintenance of volume of calvarial grafts compared with iliac bone grafts is due to enhanced osteogenesis in the former....

Dynamics of bone graft healing around implants

Directory of Open Access Journals (Sweden)

Narayan Venkataraman

2015-01-01

A few questions arise pertaining to the use of bone grafts along with implants are whether these are successful in approximation with implant. Do they accelerate bone regeneration? Are all defects ultimately regenerated with new viable bone? Is the bone graft completely resorbed or integrated in new bone? Does the implant surface characteristic positively affect osseointegration when used with a bone graft? What type of graft and implant surface can be used that will have a positive effect on the healing type and time? Finally, what are the dynamics of bone graft healing around an implant? This review discusses the cellular and molecular mechanisms of bone graft healing in general and in vicinity of another foreign, avascular body, namely the implant surface, and further, the role of bone grafts in osseointegration and/or clinical success of the implants.

Novel bone substitute material in alveolar bone healing following tooth extraction: an experimental study in sheep.

Science.gov (United States)

Liu, Jinyi; Schmidlin, Patrick R; Philipp, Alexander; Hild, Nora; Tawse-Smith, Andrew; Duncan, Warwick

2016-07-01

Electrospun cotton wool-like nanocomposite (ECWN) is a novel synthetic bone substitute that incorporates amorphous calcium phosphate nanoparticles into a biodegradable synthetic copolymer poly(lactide-co-glycolide). The objectives of this study were to develop a tooth extraction socket model in sheep for bone graft research and to compare ECWN and bovine-derived xenograft (BX) in this model. Sixteen cross-bred female sheep were used. Bilateral mandibular premolars were extracted atraumatically. Second and third premolar sockets were filled (Latin-square allocation) with BX, ECWN or left unfilled. Resorbable collagen membranes were placed over BX and selected ECWN grafted sockets. Eight sheep per time period were sacrificed after 8 and 16 weeks. Resin-embedded undemineralised sections were analysed for descriptive histology and histomorphometric analyses. At 8 weeks, there were with no distinct differences in healing among the different sites. At 16 weeks, osseous healing followed a fine trabecular pattern in ECWN sites. Non-grafted sites showed thick trabeculae separated by large areas of fibrovascular connective tissue. In BX grafted sites, xenograft particles were surrounded by newly formed bone or fibrovascular connective tissue. There were no statistically significant differences in bone formation across the four groups. However, ECWN sites had significantly less residual graft material than BX sites at 16 weeks (P = 0.048). This first description of a tooth extraction socket model in sheep supports the utility of this model for bone graft research. The results of this study suggested that the novel material ECWN did not impede bone ingrowth into sockets and showed evidence of material resorption. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Pharmacokinetics of gentamicin eluted from a regenerating bone graft substitute

DEFF Research Database (Denmark)

Stravinskas, M; Horstmann, P; Ferguson, J

2016-01-01

. Emerging bacterial resistance poses a major threat and new innovative treatment modalities are urgently needed to curb its current trajectory. MATERIALS AND METHODS: We present a new biphasic ceramic bone substitute consisting of hydroxyapatite and calcium sulphate for local antibiotic delivery...... in patients treated surgically for chronic corticomedullary osteomyelitis. RESULTS: The release pattern in vitro was comparable with the obtained release in the patient studies. No recurrence was detected in the osteomyelitis group at latest follow-up (minimum 1.5 years). CONCLUSIONS: This new biphasic bone...

Histomorphometric evaluation of a calcium-phosphosilicate putty bone substitute in extraction sockets.

Science.gov (United States)

Kotsakis, Georgios A; Joachim, Frederic P C; Saroff, Stephen A; Mahesh, Lanka; Prasad, Hari; Rohrer, Michael D

2014-01-01

The objective of this study was to evaluate bone regeneration in 24 sockets grafted with a calcium phosphosilicate putty alloplastic bone substitute. A core was obtained from 17 sockets prior to implant placement for histomorphometry at 5 to 6 months postextraction. Radiographic analysis during the same postextraction healing period showed radiopaque tissue in all sockets. Histomorphometric analysis revealed a mean vital bone content of 31.76% (± 14.20%) and residual graft content of 11.47% (± 8.99%) after a mean healing period of 5.7 months. The high percentage of vital bone in the healed sites in combination with its timely absorption rate suggest that calcium phosphosilicate putty can be a reliable choice for osseous regeneration in extraction sockets.

Investigation of novel bioactive rapidly resorbable bone substitute materials and their influence on osteoblastic cell differentiation in vivo

OpenAIRE

Jonscher, Sebastian

2010-01-01

Among the various techniques to reconstruct or enlarge a deficient alveolar ridge, the concept of guided bone regeneration (GBR) has become a predictable and well-documented surgical approach. At present, autogenous bone grafts are preferably combined with barrier membranes. Using synthetic biodegradable bone substitute materials, however, is advantageous, since it avoids second-site surgery for autograft harvesting. A bone substitute for alveolar ridge augmentation must be rapidly resorbable...

A new method to produce macroporous Mg-phosphate bone growth substitutes

Energy Technology Data Exchange (ETDEWEB)

Babaie, Elham, E-mail: Elham.Babaie@rockets.utoledo.edu [Department of Biomedical Engineering, University of Toledo, Toledo, OH 43606 (United States); Lin, Boren [Department of Biomedical Engineering, University of Toledo, Toledo, OH 43606 (United States); Bhaduri, Sarit B. [Department of Mechanical, Industrial and Manufacturing Engineering, University of Toledo, Toledo, OH 43606 (United States); Department of Surgery (Dentistry), University of Toledo, Toledo, OH 43614 (United States)

2017-06-01

This paper is a sequel to our previous effort in developing Mg-phosphate orthopedic cements using amorphous Mg-phosphate (AMP) as the precursor. In this paper, we report a new real-time in situ technique to create macroporous bone growth substitute (BGS). The method uses biodegradable Mg-particles as the porogen. As opposed to the conventional wisdom of providing corrosion protection layers to biodegradable Mg-alloys, the present method uses the fast corrosion kinetics of Mg to create macropores in real time during the setting of the cement. An aqueous solution of PVA was used as the setting solution. Using this technique, a macroporous cement containing up to 91% porosity is obtained, as determined by pycnometry. Due to formation of H{sub 2} gas bubbles from corrosion of Mg, the cement becomes macroporous. The pore sizes as big as 760 μm were observed. The results of SBF soaking indicated change in crystallinity as confirmed via scanning electron microscopy (SEM) and X-ray diffraction (XRD). Our in vitro cytocompatibility evaluation also revealed that the macroporous bone growth substitute composed of bobierrite is cytocompatible and can improve gene expression. - Highlights: • We report a new real time, in situ technique to fabricate macroporous bone grafts. • Self-corroding Mg granules act as porogens. • Compositions containing AMP and PVA self-set within a reasonable time. • The final bone graft substitute showed promising biocompatibility. • The results provide important information on the porosity content and bioactivity.

Bone Regeneration Using a Mixture of Silicon-Substituted Coral HA and β-TCP in a Rat Calvarial Bone Defect Model

Directory of Open Access Journals (Sweden)

Jiyeon Roh

2016-02-01

Full Text Available The demand of bone graft materials has been increasing. Among various origins of bone graft materials, natural coral composed of up to 99% calcium carbonate was chosen and converted into hydroxyapatite (HA; silicon was then substituted into the HA. Then, the Si-HA was mixed with β-tricalcium phosphate (TCP in the ratios 100:0 (S100T0, 70:30 (S70T30, 60:40 (S60T40, and 50:50 (S50T50. The materials were implanted for four and eight weeks in a rat calvarial bone defect model (8 mm. The MBCPTM (HA:β-TCP = 60:40, Biomatalante, Vigneux de Bretagne, France was used as a control. After euthanasia, the bone tissue was analyzed by making histological slides. From the results, S60T40 showed the fastest bone regeneration in four weeks (p < 0.05. In addition, S60T40, S50T50, and MBCPTM showed significant new bone formation in eight weeks (p < 0.05. In conclusion, Si-HA/TCP showed potential as a bone graft material.

Physical and chemical characteristics of Vietnamese natural corals used as substitutes for bone grafts

International Nuclear Information System (INIS)

Tran Cong Toai; To Phuong Vu; Tran Bac Hai; Doan Binh

1999-01-01

Coral has been used as substitutes for bone grafts in France and the United State of American. In Vietnam, research on coral has been done at the Biomaterial Research Laboratory, The University Training Centre since 1994. Among the studies are the determination of physical and chemical characteristics of natural coral blocks obtained by the scientists of the NhaTrang Maritime Institute. We found that it was quite necessary to establish a standard formula for processing coral as biomaterial graft. The selected coral was cut into blocks approximately 1x1x1 cm or 1x1x2 cm and cleaned. We measured the density, porous rate, water loading speed (at room temperature and at boiled temperature with low pressure, mechanical strength and content of soluble protein, chitosan in coral rods. (1140 samples of three types of corals). The density of Porites australiensis was heavier than that of Porites lutea. But, Porites lutea has more porous rate than Porites australiensis. This experiment has also showed that mechanical strength of Porites australiensis was harder than that of Porites lutea. To measure the water loading speed, the coral rods were treated at boiled temperature with low pressure versus at room temperature. We found that the water loading speed of Porites australiensis at boiled temperature was faster than that at room temperature. Porites lutea and Montastrea annuligera showed as the same result. The efficiency of water loading rate is quite low approximately 116 - 121 % for 45 minutes at room temperature versus 135 - 155 % for only I 0 minutes at boiled temperature with low pressure. We measured the content of soluble protein by both Lowry and Biuret methods, the content of soluble protein after washing with 0.9% sodium chloride, 1210 degree C, 60 minutes is very low (below limit of tests). The content of chitosan from dried coral rods treated with HCI 36 - 38 % and NAOH 0.01N is about 0.1 - 0.6 %. Our study determined some physical and chemical characteristics

Application of interconnected porous hydroxyapatite ceramic block for onlay block bone grafting in implant treatment: A case report.

Science.gov (United States)

Ohta, Kouji; Tada, Misato; Ninomiya, Yoshiaki; Kato, Hiroki; Ishida, Fumi; Abekura, Hitoshi; Tsuga, Kazuhiro; Takechi, Masaaki

2017-12-01

Autogenous block bone grafting as treatment for alveolar ridge atrophy has various disadvantages, including a limited availability of sufficiently sized and shaped grafts, donor site morbidity and resorption of the grafted bone. As a result, interconnected porous hydroxyapatite ceramic (IP-CHA) materials with high porosity have been developed and used successfully in orthopedic cases. To the best of the author's knowledge, this is the first report of clinical application of an IP-CHA block for onlay grafting for implant treatment in a patient with horizontal alveolar atrophy. The present study performed onlay block grafting using an IP-CHA block to restore bone volume for implant placement in the alveolar ridge area without collecting autogenous bone. Dental X-ray findings revealed that the border of the IP-CHA block became increasingly vague over the 3-year period, whereas CT scanning revealed that the gap between the block and bone had a smooth transition, indicating that IP-CHA improved the process of integration with host bone. In follow-up examinations over a period of 5 years, the implants and superstructures had no problems. An IP-CHA block may be useful as a substitute for onlay block bone grafting in implant treatment.

Fixation of tibial plateau fractures with synthetic bone graft versus natural bone graft: a comparison study.

LENUS (Irish Health Repository)

Ong, J C Y

2012-06-01

The goal of this study was to determine differences in fracture stability and functional outcome between synthetic bone graft and natural bone graft with internal fixation of tibia plateau metaphyseal defects.

Coralline hydroxyapatite: a bone graft alternative in foot and ankle surgery.

Science.gov (United States)

Rahimi, F; Maurer, B T; Enzweiler, M G

1997-01-01

The use of coralline hydroxyapatite has become a viable bone grafting alternative. Its efficacy has been well established through multiple human and animal studies. Coralline hydroxyapatite enhances osteogenesis by providing a biocompatible lattice for the passage and assembly of vascular, fibroblastic, and osteoblastic tissues. It also provides support for surrounding osseous structures. The uses of this material are expanding into the realm of foot and ankle surgery. Its consideration as an appropriate bone graft substitute as well as multiple case studies demonstrating its surgical applicability are discussed. The implants utilized at Thorek Hospital and Medical Center over the past eight years, with an average follow-up of three and one-half years, have proven to be a valuable resource for augmentation where an osseous defect has occurred.

Tailoring the degradation and biological response of a magnesium–strontium alloy for potential bone substitute application

International Nuclear Information System (INIS)

Han, Junjie; Wan, Peng; Ge, Ye; Fan, Xinmin; Tan, Lili; Li, Jianjun; Yang, Ke

2016-01-01

Bone defects are very challenging in orthopedic practice. There are many practical and clinical shortcomings in the repair of the defect by using autografts, allografts or xenografts, which continue to motivate the search for better alternatives. The ideal bone grafts should provide mechanical support, fill osseous voids and enhance the bone healing. Biodegradable magnesium–strontium (Mg–Sr) alloys demonstrate good biocompatibility and osteoconductive properties, which are promising biomaterials for bone substitutes. The aim of this study was to evaluate and pair the degradation of Mg–Sr alloys for grafting with their clinical demands. The microstructure and performance of Mg–Sr alloys, in vitro degradation and biological properties including in vitro cytocompatibility and in vivo implantation were investigated. The results showed that the as-cast Mg–Sr alloy exhibited a rapid degradation rate compared with the as-extruded alloy due to the intergranular distribution of the second phase and micro-galvanic corrosion. However, the initial degradation could be tailored by the coating protection, which was proved to be cytocompatible and also suitable for bone repair observed by in vivo implantation. The integrated fracture calluses were formed and bridged the fracture gap without gas bubble accumulation, meanwhile the substitutes simultaneously degraded. In conclusion, the as-cast Mg–Sr alloy with coating is potential to be used for bone substitute alternative. - Highlights: • Three different statuses of Mg–Sr alloys are used to compare the efficacy for bone graft application. • The rapid degradation is due to intergranular distribution of Mg 17 Sr 2 and galvanic corrosion. • The as-cast alloy with MAO coating exhibited tailored degradation and good biocompatibility. • The in vivo compatible degradation with bone healing is observed for the as-cast alloy with coating.

Influence of two barrier membranes on staged guided bone regeneration and osseointegration of titanium implants in dogs. Part 2: augmentation using bone graft substitutes.

Science.gov (United States)

Mihatovic, Ilja; Becker, Jürgen; Golubovic, Vladimir; Hegewald, Andrea; Schwarz, Frank

2012-03-01

To assess the influence of two barrier membranes and two bone graft substitutes on staged guided bone regeneration and osseointegration of titanium implants in dogs. Saddle-type defects were prepared in the lower jaws of 6 fox hounds and randomly filled with a natural bone mineral (NBM) and a biphasic calcium phosphate (SBC) and allocated to either an in situ gelling polyethylene glycol (PEG) or a collagen membrane (CM). At 8 weeks, modSLA titanium implants were inserted and left to heal in a submerged position. At 8+2 weeks, respectively, dissected blocks were processed for histomorphometrical analysis (e.g., mineralized tissue [MT], bone-to-implant contact [BIC]). The mean MT values (mm2) and BIC values (%) tended to be higher in the PEG groups (MT: NBM [3.4±1.7]; SBC [4.2±2]/BIC: NBM [67.7±16.9]; SBC [66.9±17.8]) when compared with the corresponding CM groups (MT: NBM [2.5±0.8]; SBC [2.3±1.6]/BIC: NBM [54.1±22.6]; SBC [61±8.7]). These differences, however, did not reach statistical significance. It was concluded that all augmentation procedures investigated supported bone regeneration and staged osseointegration of modSLA titanium implants. © 2011 John Wiley & Sons A/S.

Influence of two barrier membranes on staged guided bone regeneration and osseointegration of titanium implants in dogs: part 1. Augmentation using bone graft substitutes and autogenous bone.

Science.gov (United States)

Schwarz, Frank; Mihatovic, Ilja; Golubovic, Vladimir; Hegewald, Andrea; Becker, Jürgen

2012-01-01

To assess the influence of two barrier membranes and two bone graft substitutes mixed with autogenous bone (AB) on staged guided bone regeneration and osseointegration of titanium implants in dogs. Four saddle-type defects each were prepared in the upper jaw of six fox hounds and randomly filled with a natural bone mineral (NBM)+AB and a biphasic calcium phosphate (SBC)+AB and allocated to either an in situ gelling polyethylene glycol (PEG) or a collagen membrane (CM). At 8 weeks, modSLA titanium implants were inserted and left to heal in a submerged position. At 8+2 weeks, dissected blocks were processed for histomorphometrical analysis (e.g., treated area [TA], bone-to-implant contact [BIC]). The mean TA values (mm(2) ) and BIC values (%) tended to be higher in the PEG groups(TA: NBM+AB [10.4 ± 2.5]; SBC+AB [10.4 ± 5.8]/BIC: NBM+AB [86.4 ± 20.1]; SBC+AB [80.1 ± 21.5]) when compared with the corresponding CM groups (TA: NBM+AB [9.7 ± 4.8]; SBC+AB [7.8 ± 4.3]/BIC: NBM+AB [71.3 ± 20.8]; SBC+AB [72.4 ± 20.3]). A significant difference was observed for the mean TA values in the SBC+AB groups. It was concluded that all augmentation procedures investigated supported bone regeneration and staged osseointegration of modSLA titanium implants. However, the application of PEG may be associated with increased TA values. © 2011 John Wiley & Sons A/S.

Can we improve fixation and outcomes? Use of bone substitutes.

Science.gov (United States)

Moroni, Antonio; Larsson, Sune; Hoang Kim, Amy; Gelsomini, Letizia; Giannoudis, Peter V

2009-07-01

Hip fractures secondary to osteoporosis are common in the elderly. Stabilizing these fractures until union is achieved is a challenge due to poor bone stock and insufficient purchase of the implant to the bone. The reported high rate of complications has prompted extensive research in the development of fixation techniques. Furthermore, manipulation of both the local fracture environment in terms of application of growth factors, scaffolds, and mesenchymal cells and the systemic administration of agents promoting bone formation and bone strength has been considered as a treatment option with promising results. There are only a few evidence-based studies reporting on fixation augmentation techniques. This article reports on the efficacy of bone graft substitutes for the fixation of hip fractures, in particular calcium phosphates, which have been used as granules, cements, and implant coatings.

Pasteurized intercalary autogenous bone graft: radiographic and scintigraphic features

International Nuclear Information System (INIS)

Ehara, Shigeru; Tamakawa, Yoshiharu; Nishida, Jun; Shiraishi, Hideo

2000-01-01

Objective. Pasteurized autogenous bone graft sterilized at a low temperature (60 C) is one option for reconstruction after resection of bone and soft tissue tumors. The purpose of this investigation was to assess the normal and abnormal radiographic and scintigraphic findings of pasteurized intercalary autogenous bone graft after resection of bone and soft tissue sarcomas.Design. This was a retrospective evaluation of the radiography and bone scintigraphy findings in patients after treatment of bone and soft tissue sarcomas using an intercalary pasteurized autogenous bone graft.Patients. Among 10 consecutive patients, eight had intercalary grafts, and they constitute the subjects of this study. All available radiography and bone scintigraphy findings were reviewed for the healing process and the possibility of complications.Results and conclusions. Healing and incorporation of the graft were observed in five patients during the follow-up, but the other three did not heal satisfactorily. Rapid incorporation of pasteurized autogenous bone graft can be demonstrated by means of radiography and bone scintigraphy. (orig.)

Minimally Invasive Alveolar Ridge Preservation Utilizing an In Situ Hardening β-Tricalcium Phosphate Bone Substitute: A Multicenter Case Series

Directory of Open Access Journals (Sweden)

Minas D. Leventis

2016-01-01

Full Text Available Ridge preservation measures, which include the filling of extraction sockets with bone substitutes, have been shown to reduce ridge resorption, while methods that do not require primary soft tissue closure minimize patient morbidity and decrease surgical time and cost. In a case series of 10 patients requiring single extraction, in situ hardening beta-tricalcium phosphate (β-TCP granules coated with poly(lactic-co-glycolic acid (PLGA were utilized as a grafting material that does not necessitate primary wound closure. After 4 months, clinical observations revealed excellent soft tissue healing without loss of attached gingiva in all cases. At reentry for implant placement, bone core biopsies were obtained and primary implant stability was measured by final seating torque and resonance frequency analysis. Histological and histomorphometrical analysis revealed pronounced bone regeneration (24.4 ± 7.9% new bone in parallel to the resorption of the grafting material (12.9 ± 7.7% graft material while high levels of primary implant stability were recorded. Within the limits of this case series, the results suggest that β-TCP coated with polylactide can support new bone formation at postextraction sockets, while the properties of the material improve the handling and produce a stable and porous bone substitute scaffold in situ, facilitating the application of noninvasive surgical techniques.

Revascularisation of fresh compared with demineralised bone grafts in rats

DEFF Research Database (Denmark)

Solheim, E; Pinholt, E M; Talsnes, O

2001-01-01

Revascularisation of bone grafts is influenced by both the anatomical origin and the pre-implantation processing of the graft. We investigated the revascularisation by entrapment of 141Ce (cerium)-labelled microspheres in large, fresh and demineralised syngeneic grafts of predominantly cancellous...... (iliac bone) or cortical (tibial diaphysis) bone three weeks after heterotopic implantation in rats. The mean (SD) 141Ce deposition index (counts per minute (cpm) of mg recovered implant/cpm of mg host iliac bone) was higher in fresh iliac bone grafts, 0.98 (0.46) compared to that of demineralised iliac...... bone, 0.32 (0.20), p bone grafts, 0.51 (0.27), p = 0.007. We found no significant difference in the mean 141Ce deposition index between fresh tibial bone grafts and demineralised tibial bone grafts, 0.35 (0.42), p = 0.4, or between demineralised tibial grafts and demineralised...

Using radionuclide imaging for monitoring repairment of bone defect with tissue-engineered bone graft in rabbits

International Nuclear Information System (INIS)

Xia Changsuo; Ye Fagang; Zou Yunwen; Ji Shixiang; Wang Dengchun

2004-01-01

Objective: To observe the effect of tissue-engineered bone grafts in repairing bone defect in rabbits, and assess the value of radionuclide for monitoring the therapeutic effect of this approach. Methods: Bilateral radial defects of 15 mm in length in 24 rabbits were made. The tissue-engineered bone grafts (composite graft) contained bone marrow stromal cells (BMSCs) of rabbits and calcium phosphate cement (CPC) were grafted in left side defects, CPC only grafts (artificial bone graft) in right defects. After the operation, radionuclide was used to monitor the therapeutic effects at 4, 8 and 12 weeks. Results: 99 Tc m -methylene diphosphonic acid (MDP) radionuclide bone imaging indicated that there was more radionuclide accumulation in grafting region of composite than that of CPC. There was significant difference between 99 Tc m -MDP uptake of the region of interest (ROI) and scintillant counts of composite bone and the artificial bone (P<0.01). Conclusion: Tissue-engineered bone grafts is eligible for repairing radial bone defects, and radionuclide imaging may accurately monitor the revascularization and bone regeneration after the bone graft implantation. (authors)

Paracrystalline Disorder from Phosphate Ion Orientation and Substitution in Synthetic Bone Mineral.

Science.gov (United States)

Marisa, Mary E; Zhou, Shiliang; Melot, Brent C; Peaslee, Graham F; Neilson, James R

2016-12-05

Hydroxyapatite is an inorganic mineral closely resembling the mineral phase in bone. However, as a biological mineral, it is highly disordered, and its composition and atomistic structure remain poorly understood. Here, synchrotron X-ray total scattering and pair distribution function analysis methods provide insight into the nature of atomistic disorder in a synthetic bone mineral analogue, chemically substituted hydroxyapatite. By varying the effective hydrolysis rate and/or carbonate concentration during growth of the mineral, compounds with varied degrees of paracrystallinity are prepared. From advanced simulations constrained by the experimental pair distribution function and density functional theory, the paracrystalline disorder prevalent in these materials appears to result from accommodation of carbonate in the lattice through random displacement of the phosphate groups. Though many substitution modalities are likely to occur in concert, the most predominant substitution places carbonate into the mirror plane of an ideal phosphate site. Understanding the mineralogical imperfections of a biologically analogous hydroxyapatite is important not only to potential bone grafting applications but also to biological mineralization processes themselves.

Radiographic analysis of pasteurized autologous bone graft

International Nuclear Information System (INIS)

Ahmed, Adel Refaat; Manabe, Jun; Kawaguchi, Noriyoshi; Matsumoto, Seiichi; Matsushita, Yasushi

2003-01-01

Local malignant bone tumor excision followed by pasteurization and subsequent reimplantation is a unique technique for reconstruction after resection of primary bone sarcomas. The purpose of this investigation was to assess the normal and abnormal long-term radiographic findings of intercalary and osteo-chondral pasteurized bone graft/implant composite. The long-term radiographic findings of pasteurized bone grafts used in reconstruction after resection of bone and soft tissue sarcomas in relation to patients' clinical data were reviewed retrospectively. Thirty-one patients (18 females, 13 males; age range 7-77 years, mean 30 years) who underwent surgery between April 1990 and January 1997 at the authors' institute constituted the material of this study. They were followed up for at least 3 years or until the patient's death (mean 69 months). The International Society of Limb Salvage graft evaluation method that assesses the fusion, resorption, fracture, graft shortening, fixation, subluxation, joint narrowing and subchondral bone was used for evaluation of the radiographs. Twenty-one patients (68%) showed complete incorporation of graft and eight patients (26%) had partial incorporation. The overall radiographic evaluation rate was 81%. Fracture (10%) and infection (16%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors. (orig.)

Radiographic analysis of pasteurized autologous bone graft

Energy Technology Data Exchange (ETDEWEB)

Ahmed, Adel Refaat [Department of Orthopedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Kamiikebukuro 1-37-1, Toshima-ku, 170-0012, Tokyo (Japan); Department of Orthopedic Surgery, Alexandria University, Alexandria (Egypt); Manabe, Jun; Kawaguchi, Noriyoshi; Matsumoto, Seiichi; Matsushita, Yasushi [Department of Orthopedic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Kamiikebukuro 1-37-1, Toshima-ku, 170-0012, Tokyo (Japan)

2003-08-01

Local malignant bone tumor excision followed by pasteurization and subsequent reimplantation is a unique technique for reconstruction after resection of primary bone sarcomas. The purpose of this investigation was to assess the normal and abnormal long-term radiographic findings of intercalary and osteo-chondral pasteurized bone graft/implant composite. The long-term radiographic findings of pasteurized bone grafts used in reconstruction after resection of bone and soft tissue sarcomas in relation to patients' clinical data were reviewed retrospectively. Thirty-one patients (18 females, 13 males; age range 7-77 years, mean 30 years) who underwent surgery between April 1990 and January 1997 at the authors' institute constituted the material of this study. They were followed up for at least 3 years or until the patient's death (mean 69 months). The International Society of Limb Salvage graft evaluation method that assesses the fusion, resorption, fracture, graft shortening, fixation, subluxation, joint narrowing and subchondral bone was used for evaluation of the radiographs. Twenty-one patients (68%) showed complete incorporation of graft and eight patients (26%) had partial incorporation. The overall radiographic evaluation rate was 81%. Fracture (10%) and infection (16%) were the main complications. No local recurrence was detected. These results indicate that pasteurization of bone is a useful option for reconstruction after resection of malignant bone tumors. (orig.)

Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones.

Science.gov (United States)

Pieske, Oliver; Wittmann, Alexandra; Zaspel, Johannes; Löffler, Thomas; Rubenbauer, Bianka; Trentzsch, Heiko; Piltz, Stefan

2009-12-15

Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG) or demineralized-bone-matrix (DBM). From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10) or DBM-augmentation (n = 10). At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014). Mean duration of follow-up was 56.6 months (ICABG-group) and 41.2 months (DBM-group). All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20%) whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146). No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20%) (p = 0.146). Pain intensity were comparable in both groups (p = 0.326). However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031). With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160 euro/case). Nevertheless, this study demonstrated that the

Negative effect of rapidly resorbing properties of bioactive glass-ceramics as bone graft substitute in a rabbit lumbar fusion model.

Science.gov (United States)

Lee, Jae Hyup; Ryu, Hyun-Seung; Seo, Jun-Hyuk; Lee, Do-Yoon; Chang, Bong-Soon; Lee, Choon-Ki

2014-03-01

Bioactive glass-ceramics have the ability to directly bind to bones and have been widely used as bone graft substitutes due to their high osteoconductivity and biocompatibility. CaO-SiO2-P2O5-B2O3 glass-ceramics are known to have good osteoconductivity and are used as bone graft extenders. This study aimed to evaluate the effects of the resorbing properties of glass-ceramics in bone fusion after producing and analyzing three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with high osteoconductivity that had enhanced resorption by having an increased B2O3 content. The three types of CaO-SiO2-P2O5-B2O3 glass-ceramics with B2O3 contents of 8.0, 9.0, and 9.5 weight % were designated and grouped as P20B80, P10B90, and P5B95, respectively. Glass-ceramic types were tested for fusion rates and bone formation by employing the lumbar 5-6 intertransverse process fusion model in 51 New Zealand male rabbits. Bioactivity was assessed by soaking in simulated body fluid (SBF). In vitro study results showed sufficient hydroxycarbonate apatite layer formation occurred for P20B80 in1 day, for P10B90 in 3 days, and for P5B95 in 5 days after soaking in SBF. For the rabbit lumbar spine posterolateral fusion model, the autograft group recorded a 100% fusion rate with levels significantly higher than those of P20B80 (29.4%), P10B90 (0%), and P5B95 (14.3%), with high resorbing properties. Resorbing property differences among the three glass-ceramic groups were not significant. Histological results showed new bone formation confirming osteoconductivity in all three types of glass-ceramics. Radiomorphometric results also confirmed the resorbing properties of the three glass-ceramic types. The high resorbing properties and osteoconductivity of porous glass-ceramics can be advantageous as no glass-ceramics remain in the body. However, their relatively fast rate of resorption in the body negatively affects their role as an osteoconductive scaffold as glass-ceramics are resorbed before bony fusion.

Anterior palatal island advancement flap for bone graft coverage ...

African Journals Online (AJOL)

... Palatal Island Advancement Flap was effective in bone graft coverage in premaxillary edentulous area. Conclusion: It can be used as an aid for bone graft coverage of premaxillary edentulous ridge, where the need for mucosa is small in width but long in length. Keywords: Anterior maxilla, bone graft, dental implant, ...

Revascularization of calvarial, mandibular, tibial, and iliac bone grafts in rats

DEFF Research Database (Denmark)

Pinholt, E M; Solheim, E; Talsnes, O

1994-01-01

Some studies have suggested that membranous bone grafts undergo less resorption than endochondral grafts, and faster revascularization of the former has been proposed as the explanation. We studied fresh syngeneic full-thickness bone grafts from calvaria, mandibula, tibia diaphysis, and iliac bone...... implanted in the back muscles of young Lewis rats. As a measure of the quantity of cancellous bone in grafts before implantation, the ratio of the total area of soft-tissue spaces to the total area of the graft was measured histomorphometrically. Revascularization in grafts 3 weeks postoperatively...... was evaluated by deposit of 141Ce-labeled microspheres. Both the quantity of cancellous bone (before implantation) and the revascularization (3 weeks postoperatively) were greater in the mandibular and iliac bone grafts than in the calvarial and tibia diaphyseal grafts. The results suggest that the anatomical...

Hydrogel-embedded nanocrystalline hydroxyapatite granules (elastic blocks based on a cross-linked polyvinylpyrrolidone as bone grafting substitute in a rat tibia model

Directory of Open Access Journals (Sweden)

Dau M

2017-10-01

Full Text Available Michael Dau,1 Cornelia Ganz,2 Franziska Zaage,2 Bernhard Frerich,1 Thomas Gerber2 1Department of Oral, Maxillofacial and Plastic Surgery, University Medical Center Rostock, Rostock, Germany; 2Institute of Physics, Rostock University, Rostock, Germany Purpose: The aim of this study was to examine the in vivo characteristics and levels of integration and degradation of a ready-to-use bone grafting block with elastic properties (elastic block for the use in surgery. Materials and methods: Thirty-six male Wistar rats underwent surgical creation of a well-defined bone defect in the tibia. All created defects – one per animal – were filled with an unsintered nanocrystalline hydroxyapatite embedded either with a non-cross-linked hydrogel carrier (CONT, n=18 or a cross-linked hydrogel carrier (elastic block [EB], n=18 based on polyvinylpyrrolidone (PVP and silica sol, respectively. The animals were killed after 12 (n=12, 21 (n=12 and 63 days (n=12. The bone formation and defect healing were quantified by histomorphometric measurements made in paraffin sections. Additionally, immunohistochemical (tartrate-resistant acid phosphatase [TRAP] and alkaline phosphatase [aP], antibody-based examinations (CD68 and energy-dispersive x-ray scattering measurements of silica atom concentration were carried out. Results: A larger remaining bone defect area overall was observed in EB after 12 days and 21 days. After 63 days, similar areas of remaining bone defects were found. The amount of the remaining carrier material in EB overall was higher at all times. In CONT no residual carrier material was found at 12 days and later. CD68 analyses showed significantly lower level of CD68-positive marked cells after 21 days in CONT, and nonsignificant differences at 12 and 63 days, respectively. Additionally, a significantly higher level of aP-positive marked cells was observed in CONT after 12 days. Later on, the levels of aP-positive marked cells were slightly higher

Engineered, axially-vascularized osteogenic grafts from human adipose-derived cells to treat avascular necrosis of bone in a rat model.

Science.gov (United States)

Ismail, Tarek; Osinga, Rik; Todorov, Atanas; Haumer, Alexander; Tchang, Laurent A; Epple, Christian; Allafi, Nima; Menzi, Nadia; Largo, René D; Kaempfen, Alexandre; Martin, Ivan; Schaefer, Dirk J; Scherberich, Arnaud

2017-11-01

Avascular necrosis of bone (AVN) leads to sclerosis and collapse of bone and joints. The standard of care, vascularized bone grafts, is limited by donor site morbidity and restricted availability. The aim of this study was to generate and test engineered, axially vascularized SVF cells-based bone substitutes in a rat model of AVN. SVF cells were isolated from lipoaspirates and cultured onto porous hydroxyapatite scaffolds within a perfusion-based bioreactor system for 5days. The resulting constructs were inserted into devitalized bone cylinders mimicking AVN-affected bone. A ligated vascular bundle was inserted upon subcutaneous implantation of constructs in nude rats. After 1 and 8weeks in vivo, bone formation and vascularization were analyzed. Newly-formed bone was found in 80% of SVF-seeded scaffolds after 8weeks but not in unseeded controls. Human ALU+cells in the bone structures evidenced a direct contribution of SVF cells to bone formation. A higher density of regenerative, M2 macrophages was observed in SVF-seeded constructs. In both experimental groups, devitalized bone was revitalized by vascularized tissue after 8 weeks. SVF cells-based osteogenic constructs revitalized fully necrotic bone in a challenging AVN rat model of clinically-relevant size. SVF cells contributed to accelerated initial vascularization, to bone formation and to recruitment of pro-regenerative endogenous cells. Avascular necrosis (AVN) of bone often requires surgical treatment with autologous bone grafts, which is surgically demanding and restricted by significant donor site morbidity and limited availability. This paper describes a de novo engineered axially-vascularized bone graft substitute and tests the potential to revitalize dead bone and provide efficient new bone formation in a rat model. The engineering of an osteogenic/vasculogenic construct of clinically-relevant size with stromal vascular fraction of human adipose, combined to an arteriovenous bundle is described. This

Microtomographic and morphometric characterization of a bioceramic bone substitute in dental implantology

Directory of Open Access Journals (Sweden)

Deborah Meleo

2012-01-01

Full Text Available In recent years, bone tissue regeneration studies have led to a deeper knowledge of chemical and structural features of the best biomaterials to be used as replacements for lost bone structures, with the autologus bone still today the only graft material able to ostegenerate, osteinduct and/or osteoconduct. The difficulties of the small available amount of autologus bone, together with morbidity of a second surgical operation on the same patient, have been overcome using both synthetic and biologic substitute bones. The possibility of investigating morphometric characteristics of substitute bones makes it possible to evaluate the predictability of regenerative processes and, so far, a range of different methods have been used for the purpose. X-ray microtomography (micro-CT is a miniaturized form of conventional tomography, able to analyze the internal structure of small objects, performing three-dimensional images with high spatial resolution (<10 micron pixel size. For a correct analysis, samples need not be altered or treated in any way, as micro-CT is a non-invasive and non-destructive technique. It shows promising results in biomaterial studies and tissue engineering. This work shows the potential applications of this microtomographic technique by means of an in vitro analysis system, in characterizing morphometric features of human bone tissue, and contributes to the use of this technique in studies concerning biomaterials and bioscaffolds inserted in bone tissue.

21 CFR 872.3930 - Bone grafting material.

Science.gov (United States)

2010-04-01

... of the oral and maxillofacial region. (b) Classification. (1) Class II (special controls) for bone grafting materials that do not contain a drug that is a therapeutic biologic. The special control is FDA's “Class II Special Controls Guidance Document: Dental Bone Grafting Material Devices.” (See § 872.1(e) for...

Carbon-centered radicals in γ-irradiated bone substituting biomaterials based on hydroxyapatite.

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Sadlo, Jaroslaw; Strzelczak, Grazyna; Lewandowska-Szumiel, Malgorzata; Sterniczuk, Marcin; Pajchel, Lukasz; Michalik, Jacek

2012-09-01

Gamma irradiated synthetic hydroxyapatite, bone substituting materials NanoBone(®) and HA Biocer were examined using EPR spectroscopy and compared with powdered human compact bone. In every case, radiation-induced carbon centered radicals were recorded, but their molecular structures and concentrations differed. In compact bone and synthetic hydroxyapatite the main signal assigned to the CO(2) (-) anion radical was stable, whereas the signal due to the CO(3) (3-) radical dominated in NanoBone(®) and HA Biocer just after irradiation. However, after a few days of storage of these samples, also a CO(2) (-) signal was recorded. The EPR study of irradiated compact bone and the synthetic graft materials suggest that their microscopic structures are different. In FT-IR spectra of NanoBone(®), HA Biocer and synthetic hydroxyapatite the HPO(4) (2-) and CO(3) (2-) in B-site groups are detected, whereas in compact bone signals due to collagen dominate.

Rib Bone Graft Adjusted to Fit the Facial Asymmetry: A Frame Structure Graft.

Science.gov (United States)

Lee, Yoon Ho; Choi, Jong Hwan; Hwang, Kun; Choi, Jun Ho

2015-10-01

The authors introduce the concept of a "frame structure graft" in which a harvested rib bone was adjusted to fit facial asymmetry. On the costochondral junction of the sixth or seventh rib, a 5 cm incision was made. Through a subperiosteal dissection, the rib bone was harvested. Using a reciprocating saw, the harvested rib was scored on its anterior surface as well as its posterior surface with a partial depth at different intervals. The harvested rib bone was placed on the skin surface of the unaffected side of the face and a curvature was created exactly matching that of the unaffected side by bending the bone using a greenstick fracture. Thereafter, the graft was adjusted to conceal the asymmetry of the deficient side. The adjusted "frame structure" was transferred to the defect through the incisions on the affected side, and the "frame structure" graft was placed on the mandible or zygoma. The graft fixation was done externally with at least 2 Kirschner wires (K-wires). From January 2005 to August 2013, a total of 30 patients (13 men, 17 women, mean age 25.6 years) received a frame structure graft. All 30 patients achieved good healing at the operation site without complications. Donor-site morbidity as pneumothorax from the rib bone harvest was not found. Merits of this frame structure graft, the authors think, are that this method could allow a similar curvature to the normal side. In addition, the procedure itself is easy.

Characterisation of β-tricalcium phosphate-based bone substitute materials by electron paramagnetic resonance spectroscopy

Science.gov (United States)

Matković, Ivo; Maltar-Strmečki, Nadica; Babić-Ivančić, Vesna; Dutour Sikirić, Maja; Noethig-Laslo, Vesna

2012-10-01

β-TCP based materials are frequently used as dental implants. Due to their resorption in the body and direct contact with tissues, in order to inactivate bacteria, fungal spores and viruses, they are usually sterilized by γ-irradiation. However, the current literature provides little information about effects of the γ-irradiation on the formation and stability of the free radicals in the bone graft materials during and after sterilization procedure. In this work five different bone graft substitution materials, composed of synthetic beta tricalcium phosphate (β-TCP) and hydroxyapatite (HAP) present in the market were characterized by electron paramagnetic resonance (EPR) spectroscopy, X-ray powder diffraction (XRD), Fourier transform infrared spectroscopy (FTIR) and thermogravimetric analysis (TGA). Paramagnetic species Mn2+, Fe3+, trapped H-atoms and CO2- radicals were detected in the biphasic material (60% HAP, 40% β-TCP), while in β-TCP materials only Mn2+ andor trapped hydrogen atoms were detected. EPR analysis revealed the details of the structure of these materials at the atomic level. The results have shown that EPR spectroscopy is a method which can be used to improve the quality control of bone graft materials after syntering, processing and sterilization procedure.

Rabbit Calvarial Defect Model for Customized 3D-Printed Bone Grafts.

Science.gov (United States)

Lee, Kang-Gon; Lee, Kang-Sik; Kang, Yu-Jeoung; Hwang, Jong-Hyun; Lee, Se-Hwan; Park, Sang-Hyug; Park, Yongdoo; Cho, Young-Sam; Lee, Bu-Kyu

2018-05-01

Bone graft materials are commonly used to regenerate various bone defects, but their application is often limited because of the complex defect shape in various clinical conditions. Hence, customized bone grafts using three-dimensional (3D) printing techniques have been developed. However, conventional simple bone defect models are limited for evaluating the benefits and manufacturing accuracy of 3D-printed customized bone grafts. Thus, the aim of the present study was to develop a complex-shaped bone defect model. We designed an 8-shaped bony defect that consists of two simple circles attached to the rabbit calvarium. To determine the critical-sized defect (CSD) of the 8-shaped defects, 5.6- and 7-mm-diameter trephine burs were tested, and the 7-mm-diameter bur could successfully create a CSD, which was easily reproducible on the rabbit calvarium. The rate of new bone formation was 28.65% ± 8.63% at 16 weeks following creation of the defect. To confirm its efficacy for clinical use, the 8-shaped defect was created on a rabbit calvarium and 3D computed tomography (CT) was performed. A stereolithography file was produced using the CT data, and a 3D-printed polycaprolactone graft was fabricated. Using our 8-shaped defect model, we were able to modify the tolerances of the bone graft and calvarial defect to fabricate a more precise bone graft. Customized characteristics of the bone graft were then used to improve the accuracy of the bone graft. In addition, we confirmed the fitting ability of the 3D-printed graft during implantation of the graft. Our 8-shaped defect model on the rabbit calvarium using a 7.0-mm trephine bur may be a useful CSD model for evaluating 3D-printed graft materials.

Bone response to collagenized xenografts of porcine origin (mp3(®) ) and a bovine bone mineral grafting (4BONE(™) XBM) grafts in tibia defects: experimental study in rabbits.

Science.gov (United States)

Calvo-Guirado, José Luis; Aguilar-Salvatierra, Antonio; Ramírez-Fernández, Maria P; Maté Sánchez de Val, José E; Delgado-Ruiz, Rafael Arcesio; Gómez-Moreno, Gerardo

2016-08-01

This study aimed to carry out the evaluation of bone response of new bone formation to two different xenografts (bovine and porcine) biomaterials inserted in rabbit tibiae. The study used a total of 20 male New Zealand albino rabbits. They received a total of 40 grafts in the proximal metaphyseal areas of both tibiae. Two biomaterials were evaluated: 20 porcine xenografts, as a bone granulate (OsteoBiol(®) MP3(®) ; Tecnoss srl, Giaveno, Italy), were placed in the proximal metaphyseal area of the right tibia, 20 anorganic bovine bone mineral grafting (4BONE(™) XBM, MIS Implants Inc., BARLEV, Israel) were placed in the left tibia. Following graft insertion, the animals were sacrificed in two groups of 10 animals, after 1 and 4 months, respectively. For each group, biomaterials were analyzed: newly formed bone, residual graft materials and the connective tissue. Histomorphometric, EDX analysis and element mapping were performed at 1 and 4 months after graft insertion. At 4 months after treatment, the bone defects displayed radiological images that showed complete repair of osseous defects. Histomorphometric evaluation showed that for the porcine xenograft, the study averages for newly formed bone represented 84.23 ± 2.9%, while bovine matrix was 79.34 ± 2.1%. For residual graft material, the porcine biomaterial had 11.23 ± 1.7% and the bovine graft 31.56 ± 2.3%. Finally, the connective tissue for MP3 was 10.33 ± 1.8%, while for the 4BONE(™) XBM we obtained 14.34 ± 2.9%. Element analysis revealed higher percentages of Ca (54 ± 9%) and P (35 ± 6%) in the group B than group A and control group (P MP3 material; this supports new bone formation, creates a bridge between borders, and facilitates bone ingrowth in both biomaterials. Furthermore, this study observed partial dissolution of the mineral phase of four bone graft and complete resorption of porcine MP3 biomaterial and its incorporation into the surrounding bone. Depending on

Bone morphogenic protein: an elixir for bone grafting--a review.

Science.gov (United States)

Shah, Prasun; Keppler, Louis; Rutkowski, James

2012-12-01

Bone morphogenetic proteins (BMPs) are multifunctional growth factors that belong to the transforming growth factor beta superfamily. This literature review focuses on the molecular biology of BMPs, their mechanism of action, and subsequent applications. It also discusses uses of BMPs in the fields of dentistry and orthopedics, research on methods of delivering BMPs, and their role in tissue regeneration. BMP has positive effects on bone grafts, and their calculated and timely use with other growth factors can provide extraordinary results in fractured or nonhealing bones. Use of BMP introduces new applications in the field of implantology and bone grafting. This review touches on a few unknown facts about BMP and this ever-changing field of research to improve human life.

Vascularized fibular graft in infected tibial bone loss

Directory of Open Access Journals (Sweden)

C Cheriyan Kovoor

2011-01-01

Full Text Available Background : The treatment options of bone loss with infections include bone transport with external fixators, vascularized bone grafts, non-vascularized autogenous grafts and vascularized allografts. The research hypothesis was that the graft length and intact ipsilateral fibula influenced hypertrophy and stress fracture. We retrospectively studied the graft hypertrophy in 15 patients, in whom vascularized fibular graft was done for post-traumatic tibial defects with infection. Materials and Methods : 15 male patients with mean age 33.7 years (range 18 - 56 years of post traumatic tibial bone loss were analysed. The mean bony defect was 14.5 cm (range 6.5 - 20 cm. The mean length of the graft was 16.7 cm (range 11.5 - 21 cm. The osteoseptocutaneous flap (bone flap with attached overlying skin flap from the contralateral side was used in all patients except one. The graft was fixed to the recipient bone at both ends by one or two AO cortical screws, supplemented by a monolateral external fixator. A standard postoperative protocol was followed in all patients. The hypertrophy percentage of the vascularized fibular graft was calculated by a modification of the formula described by El-Gammal. The followup period averaged 46.5 months (range 24 - 164 months. The Pearson correlation coefficient (r was worked out, to find the relationship between graft length and hypertrophy. The t-test was performed to find out if there was any significant difference in the graft length of those who had a stress fracture and those who did not and to find out whether there was any significant difference in hypertrophy with and without ipsilateral fibula union. The Chi square test was performed to identify whether there was any association between the stress fracture and the fibula union. Given the small sample size we have not used any statistical analysis to determine the relation between the percentage of the graft hypertrophy and stress fracture. Results : Graft

Allogenic bone grafts in post-traumatic juxta-articular defects: Need for allogenic bone banking.

Science.gov (United States)

Mishra, Anil Kumar; Vikas, Rohit; Agrawal, H S

2017-07-01

Allogenic bone banking provide both structural and granular bone grafts for various orthopaedic, spinal, oncological and dental surgeries. However allogenic bones, presently, are not readily available. This article discusses the clinical applications of the allogenic grafts, the screening criteria and procedure for maintenance of such a bone banking facility. This article demonstrates the effective role of allogenic bone in a case of post-traumatic bone loss situation and discusses the growing need and present situation of bone banking in our country.

Free and microvascular bone grafting in the irradiated dog mandible

International Nuclear Information System (INIS)

Altobelli, D.E.; Lorente, C.A.; Handren, J.H. Jr.; Young, J.; Donoff, R.B.; May, J.W. Jr.

1987-01-01

Microvascular and free rib grafts were placed in 4.5 cm defects in an edentate mandibular body defect 18 to 28 days after completion of 50 Gy of irradiation from a 60 Co source. The animals were sacrificed from two to forty weeks postoperatively and evaluated clinically, radiographically, and histologically. There was a marked difference in the alveolar mucosal viability with the two grafts. Mucosal dehiscence was not observed over any of the microvascular grafts, but was present in seven-eighths of the free grafts. Union of the microvascular bone graft to the host bone occurred within six weeks. In contrast, after six weeks the free graft was sequestered in all the animals. An unexpected finding with both types of graft was the marked subperiosteal bone formation. This bone appeared to be derived from the host bed, stabilizing and bridging the defects bilaterally. The results suggest that radiated periosteum may play an important role in osteogenesis

Substitution urethroplasty for anterior urethral strictures: buccal versus lingual mucosal graft.

Science.gov (United States)

Kumar, Abhay; Das, Suren K; Trivedi, Sameer; Dwivedi, Udai S; Singh, Pratap B

2010-01-01

To compare the results of substitution urethroplasty and donor site morbidity between buccal mucosal graft (BMG) and lingual mucosal graft (LMG). Patients who underwent single-stage dorsal onlay free oral mucosal graft substitution urethroplasty by Barbagli's technique between January 2004 and August 2008 were included in this study. Patients who underwent buccal (cheek, lip) mucosal graft urethroplasty were included in group I and those who underwent LMG urethroplasty (tongue) were included in group II. All patients underwent complete evaluation of the stricture including inspection of the oral cavity. Exclusion criteria were stricture length speech complications was seen in group II, but not in group I. The long-term complications of persistent oral discomfort, perioral numbness and tightness of the mouth were seen only in group I. LMG urethroplasty is a good substitute for BMG urethroplasty with equally good results of urethroplasty with lower donor site morbidity. Copyright 2010 S. Karger AG, Basel.

Press-fit Femoral Fixation in ACL Reconstruction using Bone-Patellar Tendon-Bone Graft

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Kaseb Mohammad Hasan

2009-05-01

Full Text Available Bone-patellar tendon auto graft is probably the most widely used graft for ACL reconstruction. Several methods for graft fixation have been described. To avoid intra-articular hardware we adopt biological fixation with a femoral trapezoidal press-fit fixation. A prospective study was performed on 30 consecutive active people who underwent ACL reconstruction with this technique by two surgeons between september2004 and march2007 (mean follow-up 15.2 months. Results were evaluated by an independent examiner using radiography, subjective and objective evaluation. Assessment using the IKDC knee scoring revealed 92% of the patients with a normal or nearly normal knee joint. Lysholm's score was 63.6(40- 86 preoperatively and 91.88(73-100 at the latest follow up (P < 0.005. No patient complained of instability at latest follow up. The quadriceps muscle showed mild atrophy at 3 and 6 months and at final follow-up. Five Patients complained of anterior knee pain and had a positive kneeling test. We found no graft displacement on follow up radiographs. All cases showed radiological evidence of graft osteointegration at last follow up. Our results show that press-fit fixation of trapezoidal bone graft in femoral tunnel is a simple, reliable, and cost-effective alternative for ACL recon-struction using bone-patellar tendon-bone graft.

Tibial bone fractures occurring after medioproximal tibial bone grafts for oral and maxillofacial reconstruction.

Science.gov (United States)

Kim, Il-Kyu; Cho, Hyun-Young; Pae, Sang-Pill; Jung, Bum-Sang; Cho, Hyun-Woo; Seo, Ji-Hoon

2013-12-01

Oral and maxillofacial defects often require bone grafts to restore missing tissues. Well-recognized donor sites include the anterior and posterior iliac crest, rib, and intercalvarial diploic bone. The proximal tibia has also been explored as an alternative donor site. The use of the tibia for bone graft has many benefits, such as procedural ease, adequate volume of cancellous and cortical bone, and minimal complications. Although patients rarely complain of pain, swelling, discomfort, or dysfunction, such as gait disturbance, both patients and surgeons should pay close attention to such after effects due to the possibility of tibial fracture. The purpose of this study is to analyze tibial fractures that occurring after osteotomy for a medioproximal tibial graft. An analysis was intended for patients who underwent medioproximal tibial graft between March 2004 and December 2011 in Inha University Hospital. A total of 105 subjects, 30 females and 75 males, ranged in age from 17 to 78 years. We investigated the age, weight, circumstance, and graft timing in relation to tibial fracture. Tibial fractures occurred in four of 105 patients. There were no significant differences in graft region, shape, or scale between the fractured and non-fractured patients. Patients who undergo tibial grafts must be careful of excessive external force after the operation.

Nostril Base Augmentation Effect of Alveolar Bone Graft

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Woojin Lee

2013-09-01

Full Text Available Background The aims of alveolar bone grafting are closure of the fistula, stabilization ofthe maxillary arch, support for the roots of the teeth adjacent to the cleft on each side.We observed nostril base augmentation in patients with alveolar clefts after alveolar bonegrafting. The purpose of this study was to evaluate the nostril base augmentation effect ofsecondary alveolar bone grafting in patients with unilateral alveolar cleft.Methods Records of 15 children with alveolar clefts who underwent secondary alveolar bonegrafting with autogenous iliac cancellous bone between March of 2011 and May of 2012 werereviewed. Preoperative and postoperative worm’s-eye view photographs and reconstructedthree-dimensional computed tomography (CT scans were used for photogrammetry. Thedepression of the nostril base and thickness of the philtrum on the cleft side were measuredin comparison to the normal side. The depression of the cleft side pyriform aperture wasmeasured in comparison to the normal side on reconstructed three-dimensional CT.Results Significant changes were seen in the nostril base (P=0.005, the philtrum length(P=0.013, and the angle (P=0.006. The CT measurements showed significant changes in thepyriform aperture (P<0.001 and the angle (P<0.001.Conclusions An alveolar bone graft not only fills the gap in the alveolar process but alsoaugments the nostril base after surgery. In this study, only an alveolar bone graft was performedto prevent bias from other procedures. Nostril base augmentation can be achieved byperforming alveolar bone grafts in children, in whom invasive methods are not advised.

Local vs. systemic administration of bisphosphonates in rat cleft bone graft: A comparative study.

Directory of Open Access Journals (Sweden)

Christine Hong

Full Text Available A majority of patients with orofacial cleft deformity requires cleft repair through a bone graft. However, elevated amount of bone resorption and subsequent bone graft failure remains a significant clinical challenge. Bisphosphonates (BPs, a class of anti-resorptive drugs, may offer great promise in enhancing the clinical success of bone grafting. In this study, we compared the effects of systemic and local delivery of BPs in an intraoral bone graft model in rats. We randomly divided 34 female 20-week-old Fischer F344 Inbred rats into four groups to repair an intraoral critical-sized defect (CSD: (1 Control: CSD without graft (n = 4; (2 Graft/Saline: bone graft with systemic administration of saline 1 week post-operatively (n = 10; (3 Graft/Systemic: bone graft with systemic administration of zoledronic acid 1 week post-operatively (n = 10; and (4 Graft/Local: bone graft pre-treated with zoledronic acid (n = 10. At 6-weeks post-operatively, microCT volumetric analysis showed a significant increase in bone fraction volume (BV/TV in the Graft/Systemic (62.99 ±14.31% and Graft/Local (69.35 ±13.18% groups compared to the Graft/Saline (39.18±10.18%. Similarly, histological analysis demonstrated a significant increase in bone volume in the Graft/Systemic (78.76 ±18.00% and Graft/Local (89.95 ±4.93% groups compared to the Graft/Saline (19.74±18.89%. The local delivery approach resulted in the clinical success of bone grafts, with reduced graft resorption and enhanced osteogenesis and bony integration with defect margins while avoiding the effects of BPs on peripheral osteoclastic function. In addition, local delivery of BPs may be superior to systemic delivery with its ease of procedure as it involves simple soaking of bone graft materials in BP solution prior to graft placement into the defect. This new approach may provide convenient and promising clinical applications towards effectively managing cleft patients.

Nuclear accidents and bone marrow graft

International Nuclear Information System (INIS)

Bernard, J.

1988-01-01

In case of serious contamination, the only efficacious treatment is the bone marrow grafts. The graft types and conditions have been explained. To restrict the nuclear accidents consequences, it is recommended to: - take osseous medulla of the personnel exposed to radiations and preserve it , that permits to carry out rapidly the auto-graft in case of accidents; - determine, beforehand, the HLA group of the personnel; - to register the voluntary donors names and addresses, and their HLA group, that permits to find easily a compatible donar in case of allo-graft. (author)

Safety of recombinant human platelet-derived growth factor-BB in Augment® Bone Graft

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Luis A Solchaga

2012-12-01

Full Text Available This article discusses nonclinical and clinical data regarding the safety of recombinant human platelet-derived growth factor-BB as a component of the Augment® Bone Graft (Augment. Augment is a bone graft substitute intended to be used as an alternative to autologous bone graft in the fusion of hindfoot and ankle joints. Nonclinical studies included assessment of the pharmacokinetic profile of intravenously administered recombinant human platelet-derived growth factor-BB in rat and dog, effects of intravenous administration of recombinant human platelet-derived growth factor-BB in a reproductive and development toxicity study in rats, and chronic toxicity and carcinogenicity of Augment in a 12-month implantation model. These studies showed that systemic exposure was brief and clearance was rapid. No signs of toxicity, carcinogenicity, or tumor promotion were observed even with doses far exceeding the maximum clinical dose. Results of clinical trials (605 participants and commercial use of recombinant human platelet-derived growth factor-BB containing products indicate that these products are not associated with increased incidence of adverse events or cancer. The safety data presented provide evidence that recombinant human platelet-derived growth factor-BB is a safe therapeutic when used in combination products as a single administration during surgical procedures for bone repair and fusion. There is no evidence associating use of recombinant human platelet-derived growth factor-BB in Augment with chronic toxicity, carcinogenicity, or tumor promotion.

Is Bone Grafting Necessary in the Treatment of Malunited Distal Radius Fractures?

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Disseldorp, Dominique J. G.; Poeze, Martijn; Hannemann, Pascal F. W.; Brink, Peter R. G.

2015-01-01

Background Open wedge osteotomy with bone grafting and plate fixation is the standard procedure for the correction of malunited distal radius fractures. Bone grafts are used to increase structural stability and to enhance new bone formation. However, bone grafts are also associated with donor site morbidity, delayed union at bone–graft interfaces, size mismatch between graft and osteotomy defect, and additional operation time. Purpose The goal of this study was to assess bone healing and secondary fracture displacement in the treatment of malunited distal radius fractures without the use of bone grafting. Methods Between January 1993 and December 2013, 132 corrective osteotomies and plate fixations without bone grafting were performed for malunited distal radius fractures. The minimum follow-up time was 12 months. Primary study outcomes were time to complete bone healing and secondary fracture displacement. Preoperative and postoperative radiographs during follow-up were compared with each other, as well as with radiographs of the uninjured side. Results All 132 osteotomies healed. In two cases (1.5%), healing took more than 4 months, but reinterventions were not necessary. No cases of secondary fracture displacement or hardware failure were observed. Significant improvements in all radiographic parameters were shown after corrective osteotomy and plate fixation. Conclusion This study shows that bone grafts are not required for bone healing and prevention of secondary fracture displacement after corrective osteotomy and plate fixation of malunited distal radius fractures. Level of evidence Therapeutic, level IV, case series with no comparison group PMID:26261748

3D-CT evaluation of secondary alveolar bone grafts in alveolar clefts

Energy Technology Data Exchange (ETDEWEB)

Naitoh, Hiroshi; Nishimura, Yoshihiko [Kyoto Univ. (Japan). Graduate School of Medicine; Yamawaki, Yoshiroh [Kyoto Katsura Hospital (Japan); Morimoto, Naoki [Kobe City General Hospital (Japan)

2002-07-01

From 1994 to 2000, we treated 116 patients with cleft alveolus by secondary alveolar bone grafts, and 48 of them were evaluated morphologically with 3D-CT. The frequency of successful bony bridging was significantly higher in the group whose grafts were completely enveloped (including the anterior alveolar ridge) with a mucoperiosteal flap. The frequency was also significantly higher in the group who underwent bone grafts at the age of 13 or less, and canine eruptions did not influence the ratio. Some cases showed such an improved growth pattern of grafted bone that the shape of the affected maxilla resembled that of the normal side, after long-term follow-up observations. The growth increment was remarkable in anterior maxillary height. Orthodontic management guides the canine or incisor into the reconstructed area of the previous cleft. We surmise that the new occlusal position puts pressure on the grafted bone and promotes further osteogenesis. These findings show that it is important to produce sufficient bony bridge to guide the canine or incisor, not the volume of grafted bone, in secondary alveolar bone grafts. Long-term follow-up observation, after more than 2-3 years, is also necessary to evaluate secondary alveolar bone grafts. (author)

Effect of calvarial burring on resorption of onlay cranial bone graft.

Science.gov (United States)

Hassanein, Aladdin H; Clune, James E; Mulliken, John B; Arany, Praveen R; Rogers, Gary F; Kulungowski, Ann M; Greene, Arin K

2012-09-01

Variable resorption occurs whenever calvarial bone graft is used for onlay cranioplasty. The recipient ectocortex may be burred to expose vessels and osteocytes to maximize healing. The purpose of this study was to determine whether abrading the recipient site improves the volume of onlay graft. The parietal bones of 17 rabbits were sectioned into split-thickness and full-thickness grafts. The right frontal cortex was abraded with a bur to punctate bleeding. Pairs of split-thickness (n = 48) or full-thickness (n = 20) grafts were onlayed to the burred right frontal bone and to the nonburred left frontal bone. Micro-computed tomography was used to determine graft volume immediately postoperatively and 16 weeks later. Histology, including tartrate-resistant acid phosphatase staining, was performed to quantify vascular channels and osteoclasts per high-power field 10 days postoperatively. Split-thickness graft volume decreased 58.0% when placed on the burred calvarial site, compared with grafts on the nonburred cortex (28.4%) (P = 0.01). Full-thickness grafts showed a similar trend: greater resorption (39.1%) when onlayed onto abraded calvaria compared with nonburred ectocortex (26.0%) (P = 0.11). Split-thickness graft orientation (cortical vs cancellous side in contact with the recipient site) did not affect resorption (P = 0.67). Onlay grafts placed on the burred recipient site had more vascular channels (11.8) and osteoclasts (5.7), compared with grafts over nonabraded cortex (3.4 and 4.2, respectively) (P cranial bone grafting promotes resorption, possibly by increasing vascularization and osteoclastic activity. This technique cannot be recommended.

Is there evidence that barrier membranes prevent bone resorption in autologous bone grafts during the healing period? A systematic review

NARCIS (Netherlands)

Gielkens, Pepijn F. M.; Bos, Ruud R. M.; Raghoebar, Gerry M.; Stegenga, Boudewijn

2007-01-01

Introduction: Autologous bone is considered the "reference standard" for bone-grafting procedures. A barrier membrane covering an autologous bone graft (guided bone regeneration [GBR]) is expected to prevent graft resorption. Good clinical results have been reported for GBR, although potential

Biomechanical Evaluation of Glenoid Reconstruction With an Implant-Free J-Bone Graft for Anterior Glenoid Bone Loss.

Science.gov (United States)

Pauzenberger, Leo; Dyrna, Felix; Obopilwe, Elifho; Heuberer, Philipp R; Arciero, Robert A; Anderl, Werner; Mazzocca, Augustus D

2017-10-01

The anatomic restoration of glenoid morphology with an implant-free J-shaped iliac crest bone graft offers an alternative to currently widely used glenoid reconstruction techniques. No biomechanical data on the J-bone grafting technique are currently available. To evaluate (1) glenohumeral contact patterns, (2) graft fixation under cyclic loading, and (3) the initial stabilizing effect of anatomic glenoid reconstruction with the implant-free J-bone grafting technique. Controlled laboratory study. Eight fresh-frozen cadaveric shoulders and J-shaped iliac crest bone grafts were used for this study. J-bone grafts were harvested, prepared, and implanted according to a previously described, clinically used technique. Glenohumeral contact patterns were measured using dynamic pressure-sensitive sensors under a compressive load of 440 N with the humerus in (a) 30° of abduction, (b) 30° of abduction and 60° of external rotation, (c) 60° of abduction, and (d) 60° of abduction and 60° of external rotation. Using a custom shoulder-testing system allowing positioning with 6 degrees of freedom, a compressive load of 50 N was applied, and the peak force needed to translate the humeral head 10 mm anteriorly at a rate of 2.0 mm/s was recorded. All tests were performed (1) for the intact glenoid, (2) after the creation of a 30% anterior osseous glenoid defect parallel to the longitudinal axis of the glenoid, and (3) after anatomic glenoid reconstruction with an implant-free J-bone graft. Furthermore, after glenoid reconstruction, each specimen was translated anteriorly for 5 mm at a rate of 4.0 mm/s for a total of 3000 cycles while logging graft protrusion and mediolateral bending motions. Graft micromovements were recorded using 2 high-resolution, linear differential variable reluctance transducer strain gauges placed in line with the long leg of the graft and the mediolateral direction, respectively. The creation of a 30% glenoid defect significantly decreased glenohumeral

Allogeneic bone marrow grafts in genotyped swine

International Nuclear Information System (INIS)

Vaiman, M.

1974-01-01

The proof of a major histocompatibility complex (MHC) called SL-A enabled to promote bone marrow allografts. A study of the response to that kind of graft in irradiated pig states a number of interesting points. Bone marrow allografting complies with the rule of tissular compatibility with the major histocompatibility complex. The taking of SL-A incompatible bone marrow allografts could not be achieved under the experimental conditions. In spite of the high doses of radiation, 950 to 1050 rads, higher than 1.5 LD 100%, recipients were capable of rejecting their grafts, regularly. SL-A identify ensured 100%, initial achievement. However, animals developed regular fatal disease within a fairly short time. This development could by no means, be ascribed to the sole sequealae of radiation sickness since autografted animals at equal or even higher doses, showed none of the symptome. Assumption of a chronic graft-vs-host reactions, induced by the minor histocompatible systems, was put foreward, but should be confirmed histopathologically [fr

The effect of infection and lag screw fixation on revascularization and new bone deposition in membranous bone grafts in a rabbit model.

Science.gov (United States)

Fialkov, J A; Phillips, J H; Walmsley, S L; Morava-Protzner, I

1996-08-01

We have suggested that rigid fixation of membranous bone grafts in the presence of infection may improve graft-recipient bone union by facilitating graft revascularzation. To test this hypothesis, we grafted autogenous membranous bone grafts to the mandibles of 94 New Zealand White rabbits. Lag screw fixation was applied in half the animals. The wounds were inoculated with a range of Staphylococcus aureus doses. Infected and noninfected rabbits were injected weekly over a 5-week course with fluorescein bone markers and with a marker of vascular endothelium (procion red) just prior to sacrifice. Revascularization and new bone deposition in the grafts were then quantified histologically for the 75 rabbits available for data collection. Infection decreased the amount of graft revascularized and the amount of new bone deposited for both rigidly fixated and nonfixated grafts. Grafts fixated with a lag screw showed a greater amount of revascularization and new bone deposition in the presence and absence of infection when compared with nonfixated grafts, supporting the hypothesis that rigid fixation of membranous bone grafts in the presence of infection may promote graft survival and union by improving revascularization and osteogenesis within the graft.

Lyophilized allogeneic bone grafts for cystic and discontinuity defects of the jaws

International Nuclear Information System (INIS)

Pill Hoon Choung; Eun Seok Kim

1999-01-01

Allogenic bone grafts have been used after various processing in each institute was made by lyophilized allogenic bone and used for maxillofacial reconstruction. Three types of lyophilized allogenic bone grafts as powder, chip and block form were performed to reconstruct the following defects: 1) maxillectomy, 2) mandiblectomy, 3) cystectomy, 4) cleft alveolus, 5) gap in orthognathic osteotomy, 6) peri-implant defect, 7) extraction socket, and 8) facial contouring. Above defects can be classified as cystic and discontinuity defects of the maxilia and the mandible. Because discontinuity defects have more difficult problems to reconstruct considering mechanical strength of the allogenic bone. We performed allogenic bone grafts on 50 cystic defects and 12 discontinuity defects of the jaws. Among them, 3 cases were removed due to infection, and the others had no complications. In reconstruction of cystic defects, the defects were filled with allogenic chip which were made from allogenic block bone at the surgery, which later were changed to host bone. Three cases of them showed tooth eruption through the allogenic bone grafting site, changing the eruption pathway, which was interrupted by the lesion. in reconstruction of discontinuity defects, usually allogenic bone has been used as a tray, in which PMCB or demineralized bone chips were filled. But we tried to reconstruct this discontinuity defect using allogeneic bone block without inside filling of PMCB different from tray type. We will present the results of allogenic bone grafts using cranial bone, costochondral graft, and the mandible

The relationship between revascularisation and osteogenesis in fresh or demineralised bone grafts

DEFF Research Database (Denmark)

Solheim, E; Pinholt, E M; Talsnes, O

2001-01-01

Bone formation generally depends on adequate blood flow. Failure of bone grafts has been attributed to delayed revascularisation of the graft. We compared the relationship between revascularisation and osteogenesis, evaluated as entrapment of (141)Ce-labelled microspheres and uptake of (85)Sr......, respectively, in fresh or demineralised syngeneic bone grafts 3 weeks after heterotopic implantation in rats. Whereas a moderately high linear correlation between (85)Sr and (141)Ce radioactivity was found both in the (intact) host iliac bone (r = 0.75, p = 0.0001) and implanted fresh syngeneic grafts (r = 0...

The influence of bone graft procedures on primary stability and bone change of implants placed in fresh extraction sockets.

Science.gov (United States)

Jun, Sang Ho; Park, Chang-Joo; Hwang, Suk-Hyun; Lee, Youn Ki; Zhou, Cong; Jang, Hyon-Seok; Ryu, Jae-Jun

2018-12-01

This study was to evaluate the effect of bone graft procedure on the primary stability of implants installed in fresh sockets and assess the vertical alteration of peri-implant bone radiographically. Twenty-three implants were inserted in 18 patients immediately after tooth extraction. The horizontal gap between the implant and bony walls of the extraction socket was grafted with xenografts. The implant stability before and after graft procedure was measured by Osstell Mentor as implant stability quotient before bone graft (ISQ bbg) and implant stability quotient after bone graft (ISQ abg). Peri-apical radiographs were taken to measure peri-implant bone change immediately after implant surgery and 12 months after implant placement. Data were analyzed by independent t test; the relationships between stability parameters (insertion torque value (ITV), ISQ abg, and ISQ bbg) and peri-implant bone changes were analyzed according to Pearson correlation coefficients. The increase of ISQ in low primary stability group (LPSG) was 6.87 ± 3.62, which was significantly higher than the increase in high primary stability group (HPSG). A significant correlation between ITV and ISQ bbg ( R  = 0.606, P  = 0.002) was found; however, age and peri-implant bone change were not found significantly related to implant stability parameters. It was presented that there were no significant peri-implant bone changes at 1 year after bone graft surgery. Bone graft procedure is beneficial for increasing the primary stability of immediately placed implants, especially when the ISQ of implants is below 65 and that bone grafts have some effects on peri-implant bone maintenance.

A Comparative Analysis of Recombinant Human Bone Morphogenetic Protein-2 with a Demineralized Bone Matrix versus Iliac Crest Bone Graft for Secondary Alveolar Bone Grafts in Patients with Cleft Lip and Palate: Review of 501 Cases.

Science.gov (United States)

Hammoudeh, Jeffrey A; Fahradyan, Artur; Gould, Daniel J; Liang, Fan; Imahiyerobo, Thomas; Urbinelli, Leo; Nguyen, JoAnna T; Magee, William; Yen, Stephen; Urata, Mark M

2017-08-01

Alveolar cleft reconstruction using iliac crest bone graft is considered standard of care for children with complete cleft lip and palate at the time of mixed dentition. Harvesting bone may result in donor-site morbidity and additional operating time and length of hospitalization. Recombinant human bone morphogenetic protein (rhBMP)-2 with a demineralized bone matrix is an alternative bone source for alveolar cleft reconstruction. The authors investigated the outcomes of rhBMP-2/demineralized bone matrix versus iliac crest bone graft for alveolar cleft reconstruction by reviewing postoperative surgical complications and cleft closure. A retrospective chart review was conducted for 258 rhBMP-2/demineralized bone matrix procedures (mean follow-up, 2.9 years) and 243 iliac crest bone graft procedures (mean follow-up, 4.1 years) on 414 patients over a 12-year period. The authors compared complications, canine eruption, and alveolar cleft closure between the two groups. In the rhBMP-2/demineralized bone matrix group, one patient required prolonged intubation because of intraoperative airway swelling not thought to be caused by rhBMP-2, 36 reported facial swelling and one required outpatient steroids as treatment, and 12 had dehiscence; however, half of these complications resolved without intervention. Twenty-three of the 228 rhBMP-2/demineralized bone matrix patients and 28 of the 242 iliac crest bone graft patients required repeated surgery for alveolar cleft repair. Findings for canine tooth eruption into the cleft site through the graft were similar between the groups. The rhBMP-2/demineralized bone matrix appears to be an acceptable alternative for alveolar cleft repair. The authors found no increase in serious adverse events with the use of this material. Local complications, such as swelling and minor wound dehiscence, predominantly improved without intervention. Therapeutic, III.

Relevance of bone graft viability in a goat transverse process model

NARCIS (Netherlands)

Kruyt, Moyo C.; Delawi, Diyar; Habibovic, Pamela; Oner, F. Cumhur; van Blitterswijk, Clemens; Dhert, Wouter J.A.

2009-01-01

Little is known about the mechanism by which autologous bone grafts are so successful. The relevance of viable osteogenic cells, which is a prominent difference between autologous bone graft and conventional alternatives, is especially controversial. With the emergence of bone tissue engineering,

Bone grafting in surgery about the foot and ankle: indications and techniques.

Science.gov (United States)

Fitzgibbons, Timothy C; Hawks, Michael A; McMullen, Scott T; Inda, David J

2011-02-01

Bone grafting is a common procedure in foot and ankle surgery. Historically, autogenous bone graft has most often been harvested from the ipsilateral iliac crest. However, other sites offer similar volumes of cancellous bone and are associated with fewer complications. The ipsilateral proximal tibia, distal tibia, and calcaneus provide adequate amounts of bone graft material for most arthrodesis procedures about the foot and ankle. Emerging techniques have enabled the development of a seemingly unlimited supply of alternative bone graft materials with osteoconductive properties. The osteoprogenitor cells in bone marrow aspirates can be concentrated by use of selective retention systems. These aspirate-matrix composites may be combined with allograft preparations, resulting in a product that promotes osteoconduction, osteoinduction, and osteogenesis with limited morbidity.

Dressing for alveolopalatal wounds after alveolar bone grafting.

Science.gov (United States)

Kondoh, Shoji; Matsuo, Kiyoshi; Yuzuriha, Shunsuke; Kikuchi, Nirou; Ban, Ryokuya

2003-09-01

Cotton gauze with alpha cyanoacrylate was used for alveolopalatal wound dressing after alveolar bone grafting to treat 93 alveolar clefts in 74 cleft patients to reduce mechanical injuries, tension for wound dehiscence, and adhesion of food remnants. T-shaped cotton gauze was put on the gingivoperiosteal flaps and was impregnated with cyanoacrylate. The procedure required no preoperative preparation and its intraoperative execution took less than 5 minutes. The gauze with cyanoacrylate was removed approximately 1 week after surgery. No infection was observed at any of the operational sites, but tiny fistulas developed at four of them. The mean bone graft score was 1.4 point. No complications such as thermal injury resulted from the use of cyanoacrylate. Gauze impregnated with cyanoacrylate proved to be a convenient and dependable dressing for alveolopalatal wounds resulting from gingivoperiosteoplasty for alveolar bone grafting.

The ultrastructure and processing properties of Straumann Bone Ceramic and NanoBone.

Science.gov (United States)

Dietze, S; Bayerlein, T; Proff, P; Hoffmann, A; Gedrange, T

2006-02-01

The ultrastructure, fundamental chemistry, and processing modes of fully synthetic bone grafting materials are relevant to the reconstruction of osseous defects. Rapid progress in the profitable market of biomaterials has led to the development of various bone substitutes. Despite all these efforts, an ideal and full substitute of autologous bone is not yet in sight. With regard to anorganic calcium phosphate ceramics, Straumann Bone Ceramic and NanoBone are compared. These have a similar composition and are osteoconductive, which indispensably requires contact with well-vascularised bone.

Bone healing around nanocrystalline hydroxyapatite, deproteinized bovine bone mineral, biphasic calcium phosphate, and autogenous bone in mandibular bone defects

DEFF Research Database (Denmark)

Broggini, Nina; Bosshardt, Dieter D; Jensen, Simon S

2015-01-01

The individual healing profile of a given bone substitute with respect to osteogenic potential and substitution rate must be considered when selecting adjunctive grafting materials for bone regeneration procedures. In this study, standardized mandibular defects in minipigs were filled...... with nanocrystalline hydroxyapatite (HA-SiO), deproteinized bovine bone mineral (DBBM), biphasic calcium phosphate (BCP) with a 60/40% HA/β-TCP (BCP 60/40) ratio, or particulate autogenous bone (A) for histological and histomorphometric analysis. At 2 weeks, percent filler amongst the test groups (DBBM (35.65%), HA......-SiO (34.47%), followed by BCP 60/40 (23.64%)) was significantly higher than the more rapidly substituted autogenous bone (17.1%). Autogenous bone yielded significantly more new bone (21.81%) over all test groups (4.91%-7.74%) and significantly more osteoid (5.53%) than BCP 60/40 (3%) and DBBM (2...

Injection of Unicameral Bone Cysts with Bone Marrow Aspirate and Demineralized Bone Matrix Avoids Open Curettage and Bone Grafting in a Retrospective Cohort.

Science.gov (United States)

Gundle, Kenneth R; Bhatt, Etasha M; Punt, Stephanie E; Bompadre, Viviana; Conrad, Ernest U

2017-01-01

Many treatment options exist for unicameral bone cysts (UBC), without clear evidence of superiority. Meta-analyses have been limited by small numbers of patients in specific anatomic and treatment subgroups. The purpose of this study was to report the outcomes of injecting bone marrow aspirate and demineralized bone matrix (BMA/DBM) for the treatment of proximal humerus UBC. Fifty-one patients with proximal humerus lesions treated by BMA/DBM injection were retrospectively reviewed from a single academic medical center. The mean number of injections performed per patient was 2.14 (range 1-5). Eleven patients underwent only one injection (22%), an additional 19 patients completed treatment after two injections (37%), four patients healed after three injections (8%), and one patient healed after four injections (2%). The cumulative success rate of serial BMA/DBM injections was 22% (11/51), 58% (30/51), 67% (34/51), and 69% (35/51). Eleven patients (22%) ultimately underwent open curettage and bone grafting, and five patients (10%) were treated with injection of calcium phosphate bone substitute. A BMA/DBM injection strategy avoided an open procedure in 78% of patients with a proximal humerus UBC. The majority of patients underwent at least 2 injection treatments. Level IV retrospective cohort study.

Quantitation of mandibular ramus volume as a source of bone grafting.

Science.gov (United States)

Verdugo, Fernando; Simonian, Krikor; Smith McDonald, Roberto; Nowzari, Hessam

2009-10-01

When alveolar atrophy impairs dental implant placement, ridge augmentation using mandibular ramus graft may be considered. In live patients, however, an accurate calculation of the amount of bone that can be safely harvested from the ramus has not been reported. The use of a software program to perform these calculations can aid in preventing surgical complications. The aim of the present study was to intra-surgically quantify the volume of the ramus bone graft that can be safely harvested in live patients, and compare it to presurgical computerized tomographic calculations. The AutoCAD software program quantified ramus bone graft in 40 consecutive patients from computerized tomographies. Direct intra-surgical measurements were recorded thereafter and compared to software data (n = 10). In these 10 patients, the bone volume was also measured at the recipient sites 6 months post-sinus augmentation. The mandibular second and third molar areas provided the thickest cortical graft averaging 2.8 +/- 0.6 mm. The thinnest bone was immediately posterior to the third molar (1.9 +/- 0.3 mm). The volume of ramus bone graft measured by AutoCAD averaged 0.8 mL (standard deviation [SD] 0.2 mL, range: 0.4-1.2 mL). The volume of bone graft measured intra-surgically averaged 2.5 mL (SD 0.4 mL, range: 1.8-3.0 mL). The difference between the two measurement methods was significant (p AutoCAD software program did not overestimate the volume of bone that can be safely harvested from the mandibular ramus.

Stability of dental implants in grafted bone in the anterior maxilla: longitudinal study.

LENUS (Irish Health Repository)

Al-Khaldi, Nasser

2010-06-06

We aimed to assess the stability over time of dental implants placed in grafted bone in the maxilla using resonance frequency analysis, and to compare the stability of implants placed in grafted and non-grafted bone. Data were collected from 23 patients (15 test and 8 controls) in whom 64 implants (Brånemark system, Nobel Biocare, Göteborg, Sweden) were placed in accordance with the two-stage surgical protocol. In the test group 36 fixtures were placed in grafted bone, and in the control group 28 fixtures were placed in non-grafted bone. Resonance frequency analysis was used to assess the test sites at implant placement and abutment connection. The mean (SD) implant stability quotient (ISQ) for test sites at the time of implant placement was 61.91 (6.68), indicating excellent primary stability, and was 63.53 (5.76) at abutment connection. ISQ values at abutment connection were similar for test and control sites. Implants placed in grafted bone compared favourably with those in non-grafted bone, and showed excellent stability.

Evaluation of 99mTc-MDP bone imaging in monitoring the muscle-pedicle bone graft osteogenic activation

International Nuclear Information System (INIS)

Sang Shibiao; Wu Yiwei; Zhang Wei; Jiang Yimin; Chen Guangxiang; Dong Tianhua

2002-01-01

Nine mature and healthy dogs were divided into 4 groups randomly. The first group consists of 3 dogs, and the rest groups, 2 dogs. Self-control way was used. The left ilium was the experimental site, where the bone piece with sartorial muscle attached was cut from ilium. The right side served as control, where the graft bone from ilium was wrapped up with silica gel, then fixed subcutaneously. The pedicled bone pieces were retrieved in 2, 4, 6, 8 weeks after surgery, the size of graft bones from two sides were the same. Survival range, osteogenic formation of muscle-pedicle bone were examined by 99m Tc-MDP bone imaging and histological method to evaluate the clinical value of treatment of ischemic osteonecrosis of the femoral head with muscle-pedicle bone grafting. The results were as follows: 1. The part of bone attached by the sartorial survived, but osteonecrosis was observed at the location of 1.2-1.7 cm from attached point of muscle. 2. There were two forms observed in the course of osteogenic activation of muscle-pedicle bone. Under the reduction of mechanical stimulation and blood supply, bone marrow tissue was replaced by fibro-granulation tissue and new capillary in the survival part, while the survival bone of proximal part grew distally and gradually replace the dead bone of distal part. 3. Histological examination revealed that small amounts of fibro-granulation tissue and new capillary appeared in 2nd week, primary trabeculae appeared in 6th week, and in 8th week, some trabeculae recovered their normal appearance and osteogenic cell reduced remarkably. 4. Survival range of muscle-pedicle graft bone was directly proportional to the width of muscle pedicle. Therefore, radionuclide bone imaging and histological examination demonstrated that muscle-pedicle graft bone was a piece of bone with relatively poor blood supply, its effect is repairing necrosis and collapse of the femoral head is limited. 99m Tc-MDP bone imaging may be an effective and first

The effect of bone marrow aspirate, bone graft and collagen composites on fixation of bone implants

DEFF Research Database (Denmark)

Babiker, Hassan; Ding, Ming; Overgaard, Søren

2007-01-01

 Introduction: Replacement of extensive local bone loss especially in revision joint arthroplasties is a significant clinical challenge. Autogenous and allogenic cancellous bone grafts have been the gold standard in reconstructive orthopaedic surgery, but it is well known that there is morbidity...... associated with harvesting of autogenous bone graft and limitations in the quantity of bone available. Disadvantages of allograft include the risk of bacterial or viral contamination and non union as well as the potential risk of disease transmission. Alternative options are attractive and continue...... to be sought. Hydroxyapatite and collagen composites have the potential in mimicking and replacing skeletal bones. Aim: This study attempted to determine the effect of hydroxyapatite/collagen composites in the fixation of bone implants. The composites used in this study is produced by Institute of Science...

Osseointegration of subperiosteal implants using bovine bone substitute and various membranes

DEFF Research Database (Denmark)

Aaboe, Merete; Schou, S.; Hjørting-Hansen, E.

2000-01-01

Osseointegration, subperiosteal implant, bone substitute, bovine bone, guided bone, regeneration, histology, rabbits......Osseointegration, subperiosteal implant, bone substitute, bovine bone, guided bone, regeneration, histology, rabbits...

Quantitation of mandibular symphysis volume as a source of bone grafting.

Science.gov (United States)

Verdugo, Fernando; Simonian, Krikor; Smith McDonald, Roberto; Nowzari, Hessam

2010-06-01

Autogenous intramembranous bone graft present several advantages such as minimal resorption and high concentration of bone morphogenetic proteins. A method for measuring the amount of bone that can be harvested from the symphysis area has not been reported in real patients. The aim of the present study was to intrasurgically quantitate the volume of the symphysis bone graft that can be safely harvested in live patients and compare it with AutoCAD (version 16.0, Autodesk, Inc., San Rafael, CA, USA) tomographic calculations. AutoCAD software program quantitated symphysis bone graft in 40 patients using computerized tomographies. Direct intrasurgical measurements were recorded thereafter and compared with AutoCAD data. The bone volume was measured at the recipient sites of a subgroup of 10 patients, 6 months post sinus augmentation. The volume of bone graft measured by AutoCAD averaged 1.4 mL (SD 0.6 mL, range: 0.5-2.7 mL). The volume of bone graft measured intrasurgically averaged 2.3 mL (SD 0.4 mL, range 1.7-2.8 mL). The statistical difference between the two measurement methods was significant. The bone volume measured at the recipient sites 6 months post sinus augmentation averaged 1.9 mL (SD 0.3 mL, range 1.3-2.6 mL) with a mean loss of 0.4 mL. AutoCAD did not overestimate the volume of bone that can be safely harvested from the mandibular symphysis. The use of the design software program may improve surgical treatment planning prior to sinus augmentation.

A new method of prefabricated vascularized allogenic bone grafts for maxillo-mandibular reconstruction

International Nuclear Information System (INIS)

Pill-Hoon Choung

1999-01-01

Although there are various applications of allogenic bone grafts, a new technique of prevascularized lyophilized allogenic bone grafting for maxillo-mandibular reconstruction will be presented. Allogenic bone has been made by author's protocol for jaw defects as a powder, chip or block bone type. The author used lyophilized allogenic bone grafts for discontinuity defects as a block bone. In those cases, neovascularization and resorption of the allogenic bone were important factors for success of grafting. To overcome the problems, the author designed the technique of prefabricated vascularization of allogenic bone, which was lyophilized cranium, with an application of bovine BMP or not. Lyophilized cranial bone was designed for the defects and was put into the scalp. After confirming a hot spot via scintigram several months later, vascularized allogenic bone was harvested pedicled on the parietotemporal fascia based on the superficial temporal artery and vein. Vascularized allogenic cranial bone was rotated into the defect and fixed rigidly. Postoperatively, there was no severe resorption and functional disturbance of the mandible. In this technique, BMP seems to be an important role to help osteogenesis and neovascularization. Eight patients underwent prefabricated vascularization of allogenic bone grafts. Among them, four cases of reconstruction in mandibular discontinuity defects and one case of reconstruction in maxillectomy defect underwent this method, which will be presented with good results. This method may be an alternative technique of microvascular free bone graft

Alveolar bone tissue engineering using composite scaffolds for drug delivery

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Tomonori Matsuno

2010-08-01

Full Text Available For many years, bone graft substitutes have been used to reconstruct bone defects in orthopedic and dental fields. However, synthetic bone substitutes such as hydroxyapatite or β-tricalcium phosphate have no osteoinductive or osteogenic abilities. Bone tissue engineering has also been promoted as an alternative approach to regenerating bone tissue. To succeed in bone tissue engineering, osteoconductive scaffolding biomaterials should provide a suitable environment for osteogenic cells and provide local controlled release of osteogenic growth factors. In addition, the scaffold for the bone graft substitute should biodegrade to replace the newly formed bone. Recent advances in bone tissue engineering have allowed the creation of composite scaffolds with tailored functional properties. This review focuses on composite scaffolds that consist of synthetic ceramics and natural polymers as drug delivery carriers for alveolar bone tissue engineering.

Central bone grafting for nonunion of fractures of the tibia: a retrospective series.

Science.gov (United States)

Ryzewicz, M; Morgan, S J; Linford, E; Thwing, J I; de Resende, G V P; Smith, W R

2009-04-01

Nonunion of the tibia associated with bone loss, previous infection, obliteration of the intramedullary canal or located in the distal metaphysis poses a challenge to the surgeon and significant morbidity to patients. We retrospectively reviewed the records of 24 patients who were treated by central bone grafting and compared them to those of 20 who were treated with a traditional posterolateral graft. Central bone grafting entails a lateral approach, anterior to the fibula and interosseous membrane which is used to create a central space filled with cancellous iliac crest autograft. Upon consolidation, a tibiofibular synostosis is formed that is strong enough for weight-bearing. This procedure has advantages over other methods of treatment for selected nonunions. Of the 24 patients with central bone grafting, 23 went on to radiographic and clinical union without further intervention. All healed within a mean of 20 weeks (10 to 48). No further bone grafts were required, and few complications were encountered. These results were comparable to those of the 20 patients who underwent posterolateral bone grafting who united at a mean of 31.3 weeks (16 to 60) but one of whom required below-knee amputation for intractable sepsis. Central bone grafting is a safe and effective treatment for difficult nonunions of the tibia.

Transalveolar sinus floor lift without bone grafting in atrophic maxilla: A meta-analysis.

Science.gov (United States)

Yan, Mingdong; Liu, Ruimin; Bai, Shuting; Wang, Min; Xia, Haibin; Chen, Jiang

2018-01-23

We performed a meta-analysis aimed to assess the clinical results after transalveolar sinus floor lift without bone grafting in the atrophic maxilla. A systematic electronic literature search was conducted in PubMed, Embase and The Cochrane Library, followed by a manual search. Two reviewers independently extracted study data and conducted quality assessments. Ten non-controlled studies including 1484 implants and eight controlled studies (5 RCTs and 3 prospective studies) including 817 implants (451 implants in the non-graft group) were enrolled in this study. The survival rate of implants via the graft-free method was 98% (95%CI 96% to 100%). There was no significant difference in the survival rate between the non-graft group and the graft group (RR: 1.02; p = 0.18). No statistically significant difference in marginal bone loss was detected between the groups at 12 months (0.57, p = 0.07) or 36 months (0.05, p = 0.61). The endo-sinus bone gain in the non-graft group was significantly lower than in the graft group at 12 months (-1.10, p = 0.0001) and 36 months (-0.74, p = 0.02). Hence, the available evidence suggests that predictable results could be acquired through transalveolar sinus floor lift without bone grafting, while there may be a trend toward more endo-sinus bone gain with bone grafts.

Prospective evaluation of chronic pain associated with posterior autologous iliac crest bone graft harvest and its effect on postoperative outcome

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Wang David A

2009-05-01

Full Text Available Abstract Background Autogenous Iliac Crest Bone Graft (ICBG has been the "gold standard" for spinal fusion. However, bone graft harvest may lead to complications, such as chronic pain, numbness, and poor cosmesis. The long-term impact of these complications on patient function and well-being has not been established but is critical in determining the value of expensive bone graft substitutes such as recombinant bone morphogenic protein. We thus aimed to investigate the long-term complications of ICBG. Our second aim was to evaluate the psychometric properties of a new measure of ICBG morbidity that would be useful for appropriately gauging spinal surgery outcomes. Methods Prospective study of patients undergoing spinal fusion surgery with autologous ICBG. The SF-36v2, Oswestry Disability Index, and a new 14-item follow-up questionnaire addressing persistent pain, functional limitation, and cosmesis were administered with an 83% response rate. Multiple regression analyses examined the independent effect of ICBG complications on physical and mental health and disability. Results The study population included 170 patients with a mean age of 51.1 years (SD = 12.2 and balanced gender (48% male. Lumbar fusion patients predominated (lumbar = 148; cervical n = 22. At 3.5 years mean follow-up, 5% of patients reported being bothered by harvest site scar appearance, 24% reported harvest site numbness, and 13% reported the numbness as bothersome. Harvest site pain resulted in difficulty with household chores (19%, recreational activity (18%, walking (16%, sexual activity (16%, work activity (10%, and irritation from clothing (9%. Multivariate regression analyses revealed that persistent ICBG complications 3.5 years post-surgery were associated with significantly worse disability and showed a trend association with worse physical health, after adjusting for age, workers' compensation status, surgical site pain, and arm or leg pain. There was no association

Prospective evaluation of chronic pain associated with posterior autologous iliac crest bone graft harvest and its effect on postoperative outcome.

Science.gov (United States)

Schwartz, Carolyn E; Martha, Julia F; Kowalski, Paulette; Wang, David A; Bode, Rita; Li, Ling; Kim, David H

2009-05-29

Autogenous Iliac Crest Bone Graft (ICBG) has been the "gold standard" for spinal fusion. However, bone graft harvest may lead to complications, such as chronic pain, numbness, and poor cosmesis. The long-term impact of these complications on patient function and well-being has not been established but is critical in determining the value of expensive bone graft substitutes such as recombinant bone morphogenic protein. We thus aimed to investigate the long-term complications of ICBG. Our second aim was to evaluate the psychometric properties of a new measure of ICBG morbidity that would be useful for appropriately gauging spinal surgery outcomes. Prospective study of patients undergoing spinal fusion surgery with autologous ICBG. The SF-36v2, Oswestry Disability Index, and a new 14-item follow-up questionnaire addressing persistent pain, functional limitation, and cosmesis were administered with an 83% response rate. Multiple regression analyses examined the independent effect of ICBG complications on physical and mental health and disability. The study population included 170 patients with a mean age of 51.1 years (SD = 12.2) and balanced gender (48% male). Lumbar fusion patients predominated (lumbar = 148; cervical n = 22). At 3.5 years mean follow-up, 5% of patients reported being bothered by harvest site scar appearance, 24% reported harvest site numbness, and 13% reported the numbness as bothersome. Harvest site pain resulted in difficulty with household chores (19%), recreational activity (18%), walking (16%), sexual activity (16%), work activity (10%), and irritation from clothing (9%). Multivariate regression analyses revealed that persistent ICBG complications 3.5 years post-surgery were associated with significantly worse disability and showed a trend association with worse physical health, after adjusting for age, workers' compensation status, surgical site pain, and arm or leg pain. There was no association between ICBG complications and mental health in

Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis.

Science.gov (United States)

Kim, Jihyeung; Park, Jin Woo; Chung, Jeehyeok; Jeong Bae, Kee; Gong, Hyun Sik; Baek, Goo Hyun

2018-01-01

We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients. IV.

Radiographic healing and remodelling of cortical and cancellous bone grafts after rigid plate fixation

International Nuclear Information System (INIS)

Waris, P.; Karaharju, E.; Slaetis, P.; Paavolainen, P.

1980-01-01

Cortical and cancellous interposition grafts, with rigid plate fixation, in the tibiofibular bones of 130 rabbits were followed radiographically for one year. The cancellous grafts healed earlier, but by 12 weeks both graft types had been incorporated, the distal host-graft interface being the last to heal. Progressive cancellous transformation in both the graft and host bone led to an increased over-all bone diameter, a widened medullary canal and a thinned porotic wall. (Auth.)

Resorbable screws for fixation of autologous bone grafts

NARCIS (Netherlands)

Raghoebar, GM; Liem, RSB; Bos, RRM; van der Wal, JE; Vissink, A

The aim of this study was to evaluate the suitability of resorbable screws made of poly (D,L-lactide) acid (PDLLA) for fixation of autologous bone grafts related to graft regeneration and osseointegration of dental implants. In eight edentulous patients suffering from insufficient retention of their

Study of Radiation Induced Radicals in HAP and β-TCP Based Bone Graft Materials by ERP Spectroscopy

International Nuclear Information System (INIS)

Maltar-Strmecki, N.; Matkovic, I.

2013-01-01

Calcium phosphates such as beta-tricalcium phosphate (β-TCP) and hydroxyapatite (HAP) are frequently used as dental implants due to proven excellent biocompatibility. Because of their resorption in the body and direct contact with tissues, in order to inactivate bacteria, fungal spores and viruses, they are usually sterilized by γ-irradiation. However, literature provides little information about effects of γ-irradiation on the formation and stability of the free radicals in the bone graft materials during and after sterilization procedure. In this study EPR (electron paramagnetic resonance) spectroscopy was used to investigate HAP and β-TCP based dental implants present on the market. Eight dental graft materials present on the market were investigated: Bioresorb R Macropore, Poresorb R -TCP, Easy-Graft T M and Cerasorb R synthetic β-tricalcium phosphates, Easy-Graft T M crystal and Ossceram R two phase synthetic CaP consisting of 60 % HAP and 40 % β-TCP, and Dexabone R and Bio-Oss R bone graft material of bovine origin. EPR study shows that this is the only technique for characterization of free radicals that can simultaneously determine not only the presence and content, but also the position and the structure of free radicals formed by γ-sterilization in the investigated materials, as well as the paramagnetic substitutions incorporated in the materials during the synthesis (such as Mn 2+ , Fe 3+ or Cr 2+ ). Additionally, EPR provides information on stability of irradiation-induced radicals (CO 2 - , trapped H-atoms, NO 3 2 etc.) and processes for reducing them. Results show that EPR should be considered as a valuable technique in improving the quality of bone graft materials, which must be sterile, and to offer the high quality, efficacy and reliable materials to the patients.(author)

Evaluation of Osteoconductive and Osteogenic Potential of a Dentin-Based Bone Substitute Using a Calvarial Defect Model

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Ibrahim Hussain

2012-01-01

Full Text Available The aim of this study was to assess the osteoconductive and osteogenic properties of processed bovine dentin using a robust rabbit calvarial defect model. In total, 16 New Zealand White rabbits were operated to create three circular defects in the calvaria. One defect was left unfilled, one filled with collected autogenous bone, and the third defect was filled with the dentin-based bone substitute. Following surgery and after a healing period of either 1 or 6 weeks, a CT scan was obtained. Following sacrificing, the tissues were processed for histological examination. The CT data showed the density in the area grafted with the dentin-based material was higher than the surrounding bone and the areas grafted with autologous bone after 1 week and 6 weeks of healing. The area left unfilled remained an empty defect after 1 week and 6 weeks. Histological examination of the defects filled with the dentin product after 6 weeks showed soft tissue encapsulation around the dentin particles. It can be concluded that the rabbit calvarial model used in this study is a robust model for the assessment of bone materials. Bovine dentin is a biostable material; however, it may not be suitable for repairing large 4-wall defects.

Reconstruction of mandibular defects with autogenous bone grafts: a review of 30 cases

International Nuclear Information System (INIS)

Sajid, M.A.; Warraich, R.A.; Abid, H.; Haq, M.E.; Shah, K.L.; Khan, Z.

2012-01-01

Multitudes of options are available for reconstruction of functional and cosmetic defects of the mandible, caused by various ailments. At the present time, autogenous bone grafting is the gold standard by which all other techniques of reconstruction of the mandible can be judged. The purpose of this study was to evaluate the outcome of different osseous reconstruction options using autogenous bone grafts for mandibular reconstruction. Methods: This Interventional study was conducted at Department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital Lahore, from January 2008 to July 2009 including one year follow-up. The study was carried out on thirty patients having bony mandibular defects. They were reconstructed with the autogenous bone grafts from different graft donor sites. On post-operative visits they were evaluated for outcome variables. Results: Success rate of autogenous bone grafts in this study was 90%. Only 10% of the cases showed poor results regarding infection, resorption and graft failure. Conclusion: Autogenous bone grafts, non-vascularized or vascularized, are a reliable treatment modality for the reconstruction of the bony mandibular defects with predictable functional and aesthetic outcome. (author)

The Application of Corals in Bone Tissue Engineering

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Iraj Nabipour

2017-05-01

Full Text Available Natural coral exoskeleton and coralline hydroxyapatite have been used as bone replacement graft for repairing of bone defects in animal models and humans since two decades ago. These bone replacement grafts have an osteoconductive, biodegradable and biocompatible features. Currently, three lines of researches in bone tissue engineering are conducting on corals. Corals have been used for construction of bony composites, stem cells attachments, and the growth factors-scaffold-based approaches. This review have paid to the wide range of coral use in clinical experiments as a bone graft substitute and cell-scaffold-based approaches in bone tissue engineering.

Osteogenic protein-1 increases the fixation of implants grafted with morcellised bone allograft and ProOsteon bone substitute: an experimental study in dogs

DEFF Research Database (Denmark)

Jensen, T B; Overgaard, S; Lind, M

2007-01-01

Impacted bone allograft is often used in revision joint replacement. Hydroxyapatite granules have been suggested as a substitute or to enhance morcellised bone allograft. We hypothesised that adding osteogenic protein-1 to a composite of bone allograft and non-resorbable hydroxyapatite granules...... (ProOsteon) would improve the incorporation of bone and implant fixation. We also compared the response to using ProOsteon alone against bone allograft used in isolation. We implanted two non-weight-bearing hydroxyapatite-coated implants into each proximal humerus of six dogs, with each implant...... surrounded by a concentric 3 mm gap. These gaps were randomly allocated to four different procedures in each dog: 1) bone allograft used on its own; 2) ProOsteon used on its own; 3) allograft and ProOsteon used together; or 4) allograft and ProOsteon with the addition of osteogenic protein-1. After three...

3D computed tomographic evaluation of secondary alveolar bone grafts in cleft lip and palate patients

Energy Technology Data Exchange (ETDEWEB)

Ohkubo, Fumio; Akai, Hidemi; Hosaka, Yoshiaki [Showa Univ., Tokyo (Japan). School of Medicine

2001-04-01

Alveolar bone grafting in patients with cleft lip and palate has becomes a routine part of most treatment regimes. This study was undertaken to estimate how much bone needs to be grafted into the cleft cavity and to evaluate the grafted bone using 3-DCT over a period from the early postoperative stage to after one year. Seventy-five patients divided into four groups according to the type of cleft were studied. All patients underwent secondary alveolar bone grafting using particulate cancellous bone from the anterior iliac crest. The bone graft areas were divided into two regions: the extra-cleft region and the intra-cleft region. The weight and the volume of the grafted bone were correlated and the average density was 1.5 g/ml regardless of the cleft type. The bone in the extra-cleft region could be seen in almost all slices of the CT scans, from the lower alveolar process to the piriform aperture. The extra-cleft graft ratio of unilateral and bilateral cleft lip and palate is higher than that of cleft lip and alveolus. The extra-cleft grafting is necessary to restore facial symmetry. The grafted bone was decreased in both height and volume following three months and adequate bone bridging was maintained for one year. We concluded that 3-DCT findings are one of the most valuable methods to evaluate postoperative conditions after alveolar bone grafting. (author)

3D computed tomographic evaluation of secondary alveolar bone grafts in cleft lip and palate patients

International Nuclear Information System (INIS)

Ohkubo, Fumio; Akai, Hidemi; Hosaka, Yoshiaki

2001-01-01

Alveolar bone grafting in patients with cleft lip and palate has becomes a routine part of most treatment regimes. This study was undertaken to estimate how much bone needs to be grafted into the cleft cavity and to evaluate the grafted bone using 3-DCT over a period from the early postoperative stage to after one year. Seventy-five patients divided into four groups according to the type of cleft were studied. All patients underwent secondary alveolar bone grafting using particulate cancellous bone from the anterior iliac crest. The bone graft areas were divided into two regions: the extra-cleft region and the intra-cleft region. The weight and the volume of the grafted bone were correlated and the average density was 1.5 g/ml regardless of the cleft type. The bone in the extra-cleft region could be seen in almost all slices of the CT scans, from the lower alveolar process to the piriform aperture. The extra-cleft graft ratio of unilateral and bilateral cleft lip and palate is higher than that of cleft lip and alveolus. The extra-cleft grafting is necessary to restore facial symmetry. The grafted bone was decreased in both height and volume following three months and adequate bone bridging was maintained for one year. We concluded that 3-DCT findings are one of the most valuable methods to evaluate postoperative conditions after alveolar bone grafting. (author)

Clinical application of human mesenchymal stromal cells for bone tissue engineering

NARCIS (Netherlands)

Ganguly, Anindita; Meijer, Gert; van Blitterswijk, Clemens; de Boer, Jan

2010-01-01

The gold standard in the repair of bony defects is autologous bone grafting, even though it has drawbacks in terms of availability and morbidity at the harvesting site. Bone-tissue engineering, in which osteogenic cells and scaffolds are combined, is considered as a potential bone graft substitute

Osteostatin-coated porous titanium can improve early bone regeneration of cortical bone defects in rats

NARCIS (Netherlands)

Van Der Stok, Johan; Lozano, Daniel; Chai, Yoke Chin; Amin Yavari, Saber; Bastidas Coral, Angela P.; Verhaar, Jan A N; Gómez-Barrena, Enrique; Schrooten, Jan; Jahr, Holger; Zadpoor, Amir A.; Esbrit, Pedro; Weinans, Harrie

2015-01-01

A promising bone graft substitute is porous titanium. Porous titanium, produced by selective laser melting (SLM), can be made as a completely open porous and load-bearing scaffold that facilitates bone regeneration through osteoconduction. In this study, the bone regenerative capacity of porous

MR imaging of avascular scaphoid nonunion before and after vascularized bone grafting

Energy Technology Data Exchange (ETDEWEB)

Anderson, Suzanne E.; Tschering-Vogel, Dechen; Martin, Matthias [University Hospital of Bern, Inselspital, Department of Radiology, Bern (Switzerland); Steinbach, Lynne S. [University of California San Francisco, Department of Radiology, San Francisco, California (United States); Nagy, Ladislav [University Hospital of Bern, Inselspital, Department of Orthopedic Surgery, Bern (Switzerland)

2005-06-01

To investigate the magnetic resonance (MR) imaging appearances of chronic nonunion of the scaphoid with proximal pole avascular necrosis before and after insertion of a vascularized bone graft, using computed tomography (CT) as the imaging gold standard. A retrospective study was performed involving MR imaging (n=26), CT scans (n=37) and radiographs (n=52) of 13 men (mean age 29 years, age range 20-38 years) with avascular scaphoid nonunion. Avascular necrosis of the scaphoid proximal pole was confirmed intraoperatively (n=13). MR images were acquired preoperatively and following placement of a vascularized bone graft. Scaphoid MR signal characteristics were assessed for evidence of vascular bone graft incorporation and revascularization of the bone marrow of the proximal pole of the scaphoid and compared with the gold standard of CT. Surgical and clinical notes were reviewed with a minimum 3 year imaging and clinical follow-up in all patients. Graft incorporation with revascularization of the proximal pole of the scaphoid was documented in 9 patients (69%). Graft failure with persistent pseudoarthrosis and avascular necrosis of the scaphoid was seen in 4 patients (31%). MR imaging is useful to determine whether vascularized bone graft incorporation and revascularization of the proximal pole of the scaphoid has occurred in the setting of avascular scaphoid nonunion. (orig.)

MR imaging of avascular scaphoid nonunion before and after vascularized bone grafting

International Nuclear Information System (INIS)

Anderson, Suzanne E.; Tschering-Vogel, Dechen; Martin, Matthias; Steinbach, Lynne S.; Nagy, Ladislav

2005-01-01

To investigate the magnetic resonance (MR) imaging appearances of chronic nonunion of the scaphoid with proximal pole avascular necrosis before and after insertion of a vascularized bone graft, using computed tomography (CT) as the imaging gold standard. A retrospective study was performed involving MR imaging (n=26), CT scans (n=37) and radiographs (n=52) of 13 men (mean age 29 years, age range 20-38 years) with avascular scaphoid nonunion. Avascular necrosis of the scaphoid proximal pole was confirmed intraoperatively (n=13). MR images were acquired preoperatively and following placement of a vascularized bone graft. Scaphoid MR signal characteristics were assessed for evidence of vascular bone graft incorporation and revascularization of the bone marrow of the proximal pole of the scaphoid and compared with the gold standard of CT. Surgical and clinical notes were reviewed with a minimum 3 year imaging and clinical follow-up in all patients. Graft incorporation with revascularization of the proximal pole of the scaphoid was documented in 9 patients (69%). Graft failure with persistent pseudoarthrosis and avascular necrosis of the scaphoid was seen in 4 patients (31%). MR imaging is useful to determine whether vascularized bone graft incorporation and revascularization of the proximal pole of the scaphoid has occurred in the setting of avascular scaphoid nonunion. (orig.)

Stiffness compatibility of coralline hydroxyapatite bone substitute under dynamic loading

Institute of Scientific and Technical Information of China (English)

REN ChaoFeng; HOU ZhenDe; ZHAO Wei

2009-01-01

When hydroxyapatite bone substitutes are implanted in human bodies, bone tissues will grow into their porous structure, which will reinforce their strength and stiffness. The concept of mechanical com-patibility of bone substitutes implies that their mechanical properties are similar to the bone tissues around, as if they were part of the bone. The mechanical compatibility of bone substitutes includes both static and dynamic behavior, due to the mechanical properties of bone depending on the strain rate. In this study, split Hopkinson pressure bar technique (SHPB) was employed to determine the dy-namic mechanical properties of coralline hydroxyapatite, bones with and bones without organic com-ponents, and their dynamic stress-strain curves of the three materials were obtained. The mechanical effects of collagens in bone were assessed, by comparing the difference between the Young's moduli of the three materials. As the implanted bone substitute becomes a part of bone, it can be regarded as an inclusion composite. The effective modulus of the composite was also evaluated in order to estimate its mechanical compatibility on stiffness. The evaluated result shows that the suitable porosity of HA is0.8, which is in favor of both static and dynamic stiffness compatibility.

Experimental Evaluation of the Effectiveness of Demineralized Bone Matrix and Collagenated Heterologous Bone Grafts Used Alone or in Combination with Platelet-Rich Fibrin on Bone Healing in Sinus Floor Augmentation.

Science.gov (United States)

Peker, Elif; Karaca, Inci Rana; Yildirim, Benay

2016-01-01

The aim of this study was an experimental evaluation of the effectiveness of demineralized bone matrix (DBM) and collagenated heterologous bone graft (CHBG) used alone or in combination with platelet-rich fibrin on bone healing in sinus floor augmentation procedures. In this study, 36 New Zealand rabbits were used. The bilateral sinus elevation was performed, and 72 defects were obtained. The rabbit maxillary sinuses were divided into four groups according to the augmentation biomaterials obtained: demineralized bone matrix (Grafton DBM Putty, Osteotech; DBM group), DBM combined with platelet-rich fibrin (PRF; DBM + PRF group), collagenated heterologous bone graft (CHBG; Apatos Mix, OsteoBiol, Tecnoss; CHBG group), CHBG combined with PRF (CHBG + PRF group). All groups were sacrificed at 2, 4, and 8 weeks after surgery for histologic, histomorphometric, and immunohistochemical analyses. The inflammatory reaction was moderate to intense at the second week in all groups and declined from 2 to 8 weeks. New bone formation was started at the second week and increased from 2 to 8 weeks in all groups. There was no significant difference in bone formation between the experimental groups that used PRF mixed graft material and control groups that used only graft material. The percentage of new bone formation showed a significant difference in DBM groups and DBM + PRF groups compared with other groups. There were osteoclasts around all the bone graft materials used, but the percentage of residual graft particles was significantly higher in CHBG groups and CHBG + PRF groups at the eighth week. There is no beneficial effect of the application of PRF in combination with demineralized bone matrix or collagenated heterologous bone graft on bone formation in sinus floor augmentation. The results of this study showed that both collagenated heterologous bone graft and demineralized bone matrix have osteoconductive properties, but demineralized bone matrix showed more bone formation

Onlay Rib Bone Graft in Elevation of Reconstructed Auricle: 17 Years of Experience

Directory of Open Access Journals (Sweden)

Taehoon Kim

2013-05-01

Full Text Available BackgroundA cartilage wedge block and covering flap are standard procedures for firm elevation of the ear in microtia correction. However, using costal cartilage for elevation of the reconstructed auricle can be insufficient, and the fixed cartilage wedge block may be absorbed or may slip out. Furthermore, elevating covering flaps is time-consuming and uses up fascia, a potential source of reconstruction material. Therefore, we propose an innovative method using autologous onlay rib bone graft for auricular elevation of microtia.MethodsFrom February 1995 to August 2012, 77 patients received a first stage operation with a rib cartilage framework graft. In the second stage operation, a small full thickness of rib bone was harvested through the previous donor scar. The bihalved rib bone was inserted into the subperiosteal pocket beneath the cartilage framework.ResultsThe follow-up time ranged from 1 month to 17 years, with a mean of 3 years. All of the patients sustained the elevation of their ears very well during the follow-up period. Donor site problems, except for hypertrophic scars, were not observed. Surgery-related complications, specifically skin necrosis, infection, or hematoma, occurred in 4 cases.ConclusionsOnlay rib bone graft used to elevate the reconstructed auricle is a more anatomically appropriate material than cartilage, due to the bone-to-bone contact between the bone graft and the temporal bone. Postoperative minor correction of the elevation degree is straightforward and the skin graft survives better. Therefore, reconstructed auricle elevation using onlay rib bone graft is a useful and valuable method.

The in vitro viability and growth of fibroblasts cultured in the presence of different bone grafting materials (NanoBone and Straumann Bone Ceramic).

Science.gov (United States)

Kauschke, E; Rumpel, E; Fanghänel, J; Bayerlein, T; Gedrange, T; Proff, P

2006-02-01

Different clinical applications, including dentistry, are making increasing demands on bone grafting material. In the present study we have analysed the viability, proliferation and growth characteristics of fibroblasts cultured in vitro together with two different bone grafting materials, NanoBone and Straumann Bone Ceramic, over a period of 24 and 28 days respectively. Viability was measured at least every 72 hours by using the alamarBlue assay, a test that measures quantitatively cell proliferation and viability but does not require cell fixation or extraction. After one week of culture fibroblast viability was as high as in controls for both grafting materials and remained high (> 90%) for the duration of the experiment. Cell growth was evaluated microscopically. Scanning electron microscopy revealed a dense fibroblast growth at the surface of both bone grafting materials after three weeks of in vitro culture. Generally, our in vitro analyses contribute to further insights into cell - scaffold interactions.

Flow perfusion culture of human mesenchymal stem cells on silicate-substituted tricalcium phosphate scaffolds

DEFF Research Database (Denmark)

Bjerre, Lea; Bünger, Cody E; Kassem, Moustapha

2008-01-01

Autologous bone grafts are currently the gold standard for treatment of large bone defects, but their availability is limited due to donor site morbidity. Different substitutes have been suggested to replace these grafts, and this study presents a bone tissue engineered alternative using silicate......-substituted tricalcium phosphate (Si-TCP) scaffolds seeded with human bone marrow-derived mesenchymal stem cells (hMSC). The cells were seeded onto the scaffolds and cultured either statically or in a perfusion bioreactor for up to 21 days and assessed for osteogenic differentiation by alkaline phosphatase activity...... assays and by quantitative real-time RT-PCR on bone markers. During culture, cells from the flow cultured constructs demonstrated improved proliferation and osteogenic differentiation verified by a more pronounced expression of several bone markers, e.g. alkaline phosphatase, osteopontin, Runx2, bone...

Long-term outcome of secondary alveolar bone grafting in cleft lip and palate patients

DEFF Research Database (Denmark)

Meyer, Steffen; Pedersen, Kirsten Mølsted

2013-01-01

The objective was to assess the long-term outcome of secondary alveolar bone grafting (SABG) in cleft lip and palate patients and to examine relationships between preoperative and postoperative factors and overall long-term bone graft success. The records of 97 patients with cleft lip and palate......, who had secondary alveolar bone grafting of 123 alveolar clefts, were examined. Interalveolar bone height was assessed radiographically a minimum of 10 years after grafting using a 4-point scale (I-IV), where types I and II were considered a success. After an average follow-up of 16 years after SABG...... to the cleft. No significant differences were found with regard to the other parameters investigated. The timing of secondary alveolar bone grafting is critical with regard to the age of the patient and the stage of eruption of the tooth distal to the cleft....

A Biphasic Calcium Sulphate/Hydroxyapatite Carrier Containing Bone Morphogenic Protein-2 and Zoledronic Acid Generates Bone

DEFF Research Database (Denmark)

Raina, Deepak Bushan; Isaksson, Hanna; Hettwer, Werner

2016-01-01

-the-shelf osteoinductive bone substitutes that can replace bone grafts are required. We tested the carrier properties of a biphasic, calcium sulphate and hydroxyapatite ceramic material, containing a combination of recombinant human bone morphogenic protein-2 (rhBMP-2) to induce bone, and zoledronic acid (ZA) to delay...

Histological study on the new bone formation of the implanted bone allograft in sheep

International Nuclear Information System (INIS)

Li Youchen; Sun Guiying; Shi Zhancheng

1999-01-01

The purpose of this study is to compare the formation of new bone in the implanted frozen irradiated bone allograft with the fresh bone autograft. The work on animal model included resection and implantation of sheep's tibial diaphysis and intramedullary nail fixation, with total number 20. Tibias were harvested at 6, 12, and 24 months after operation. Sheep were fed with tetracycline I week before bone harvesting. Bones were examined with usual and fluorescence microscopes. The results showed that the progress of graft incorporation in allografts were generally similar to that of autografts. Capillaries penetration and callus formation extended from the host end to surround the host-graft junction in 6 months. Incorporation of new bone was nearly completed in 12 months; then the speed of new bone formation was decreased, and the implanted bone graft was almost completely substituted with non-nal bone structure in 24 months

Solitary haemangioma of the shaft of long bones: resection and reconstruction with autologous bone graft.

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Li, Zhaoxu; Tang, Jicun; Ye, Zhaoming

2013-04-01

Bone haemangiomas are uncommon lesions, occurring in the skull or spine. A solitary haemangioma in the diaphysis of a long bone is rare. We retrospectively investigated six patients who presented with a solitary haemangioma in a long bone diaphysis. After segmental bone resection, the bone defect was replaced by a bone autograft. Patients were reviewed clinically and with radiographs. The mean follow-up was 6 years (range : 1-20 years). At the time of latest follow-up, no patient had a recurrence. Postoperative complications were one wound necrosis and one superficial wound infection. Union of the gap filling graft with the host bone was achieved in all patients at an average of 4 months (range: 3-8 months). The average Musculoskeletal Tumor Society functional score was 77% (range: 53%-90%) of normal at 6 months postoperatively, and 97% (range: 95%-99%) at the last follow-up evaluation. Segmental resection for solitary haemangioma and reconstruction with autologous bone graft can be considered as a suitable treatment option.

Collagen-grafted porous HDPE/PEAA scaffolds for bone reconstruction.

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Kim, Chang-Shik; Jung, Kyung-Hye; Kim, Hun; Kim, Chan-Bong; Kang, Inn-Kyu

2016-01-01

After tumor resection, bone reconstruction such as skull base reconstruction using interconnected porous structure is absolutely necessary. In this study, porous scaffolds for bone reconstruction were prepared using heat-pressing and salt-leaching methods. High-density polyethylene (HDPE) and poly(ethylene-co-acrylic acid) (PEAA) were chosen as the polymer composites for producing a porous scaffold of high mechanical strength and having high reactivity with biomaterials such as collagen, respectively. The porous structure was observed through surface images, and its intrusion volume and porosity were measured. Owing to the carboxylic acids on PEAA, collagen was successfully grafted onto the porous HDPE/PEAA scaffold, which was confirmed by FT-IR spectroscopy and electron spectroscopy for chemical analysis. Osteoblasts were cultured on the collagen-grafted porous scaffold, and their adhesion, proliferation, and differentiation were investigated. The high viability and growth of the osteoblasts suggest that the collagen-grafted porous HDPE/PEAA is a promising scaffold material for bone generation.

Stiffness compatibility of coralline hydroxyapatite bone substitute under dynamic loading

Institute of Scientific and Technical Information of China (English)

无

2009-01-01

When hydroxyapatite bone substitutes are implanted in human bodies,bone tissues will grow into their porous structure,which will reinforce their strength and stiffness.The concept of mechanical com-patibility of bone substitutes implies that their mechanical properties are similar to the bone tissues around,as if they were part of the bone.The mechanical compatibility of bone substitutes includes both static and dynamic behavior,due to the mechanical properties of bone depending on the strain rate.In this study,split Hopkinson pressure bar technique(SHPB) was employed to determine the dy-namic mechanical properties of coralline hydroxyapatite,bones with and bones without organic com-ponents,and their dynamic stress-strain curves of the three materials were obtained.The mechanical effects of collagens in bone were assessed,by comparing the difference between the Young’s moduli of the three materials.As the implanted bone substitute becomes a part of bone,it can be regarded as an inclusion composite.The effective modulus of the composite was also evaluated in order to estimate its mechanical compatibility on stiffness.The evaluated result shows that the suitable porosity of HA is 0.8,which is in favor of both static and dynamic stiffness compatibility.

Guided Bone Regeneration in Long-Bone Defects with a Structural Hydroxyapatite Graft and Collagen Membrane

Science.gov (United States)

2013-01-01

Original Articles Guided Bone Regeneration in Long-Bone Defects with a Structural Hydroxyapatite Graft and Collagen Membrane Teja Guda, PhD,1,2 John...Joint Surg Br 90-B, 1617, 2008. 6. Carlo Reis, E.C., Borges AaPB, Araujo, M.V.F., Mendes, V.C., Guan, L., and Davies, J.E. Periodontal regeneration...Regeneration of periodontal tissues: combinations of barrier membranes and grafting materials–biological foundation and preclinical evi- dence: a

Graft fixation in cruciate ligament reconstruction.

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Brand, J; Weiler, A; Caborn, D N; Brown, C H; Johnson, D L

2000-01-01

Cruciate ligament reconstruction has progressed dramatically in the last 20 years. Anatomic placement of ligament substitutes has fostered rehabilitation efforts that stress immediate and full range of motion, immediate weightbearing, neuromuscular strength and coordination, and early return to athletic competition (3 months). This has placed extreme importance on secure graft fixation at the time of ligament reconstruction. Current ligament substitutes require a bony or soft tissue component to be fixed within a bone tunnel or on the periosteum at a distance from the normal ligament attachment site. Fixation devices have progressed from metal to biodegradable and from far to near-normal native ligament attachment sites. Ideally, the biomechanical properties of the entire graft construct would approach those of the native ligament and facilitate biologic incorporation of the graft. Fixation should be done at the normal anatomic attachment site of the native ligament (aperture fixation) and, over time, allow the biologic return of the histologic transition zone from ligament to fibrocartilage, to calcified fibrocartilage, to bone. The purpose of this article is to review current fixation devices and techniques in cruciate ligament surgery.

Functional regeneration of ligament-bone interface using a triphasic silk-based graft.

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Li, Hongguo; Fan, Jiabing; Sun, Liguo; Liu, Xincheng; Cheng, Pengzhen; Fan, Hongbin

2016-11-01

The biodegradable silk-based scaffold with unique mechanical property and biocompatibility represents a favorable ligamentous graft for tissue-engineering anterior cruciate ligament (ACL) reconstruction. However, the low efficiency of ligament-bone interface restoration barriers the isotropic silk graft to common ACL therapeutics. To enhance the regeneration of the silk-mediated interface, we developed a specialized stratification approach implementing a sequential modification on isotropic silk to constitute a triphasic silk-based graft in which three regions respectively referring to ligament, cartilage and bone layers of interface were divided, followed by respective biomaterial coating. Furthermore, three types of cells including bone marrow mesenchymal stem cells (BMSCs), chondrocytes and osteoblasts were respectively seeded on the ligament, cartilage and bone region of the triphasic silk graft, and the cell/scaffold complex was rolled up as a multilayered graft mimicking the stratified structure of native ligament-bone interface. In vitro, the trilineage cells loaded on the triphasic silk scaffold revealed a high proliferative capacity as well as enhanced differentiation ability into their corresponding cell lineage. 24 weeks postoperatively after the construct was implanted to repair the ACL defect in rabbit model, the silk-based ligamentous graft exhibited the enhancement of osseointegration detected by a robust pullout force and formation of three-layered structure along with conspicuously corresponding matrix deposition via micro-CT and histological analysis. These findings potentially broaden the application of silk-based ligamentous graft for ACL reconstruction and further large animal study. Copyright © 2016 Elsevier Ltd. All rights reserved.

Autologous serum improves bone formation in a primary stable silica-embedded nanohydroxyapatite bone substitute in combination with mesenchymal stem cells and rhBMP-2 in the sheep model

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Boos AM

2014-11-01

in the group with autologous serum and after 12 weeks in every experimental group. This study clearly demonstrates the positive effects of autologous serum in combination with mesenchymal stem cells and rhBMP-2 on bone formation in a primary stable silica-embedded nano-HA bone grafting material in the sheep model. In further experiments, the results will be transferred to the sheep arteriovenous loop model in order to engineer an axially vascularized primary stable bone replacement in clinically relevant size for free transplantation. Keywords: nanostructured bone substitute, bone tissue engineering, autologous serum, mesenchymal stem cells, recombinant human bone morphogenetic protein 2, sheep model

Allogenic bone grafts used at Central Hospital during June 1995 to July 1998

International Nuclear Information System (INIS)

Yolchai Jongjirasiri; Yongyudh Vajaradul

1999-01-01

Producing and using allogenic bone graft in Thailand began ten years ago. There are approximately 1,000 cases a year on orthopaedic surgery at Central Hospital. For using allogenic bone graft from the Bangkok Biomaterial Center, 66 cases were operated since June 1995. This was generated by 30 in males, 36 in females and by ages between 12-81 years old. After the operation, 43 cases had bone gap from injuries and 19 cases, fusion of spondylolisthesis and scoliosis were done. Four cases had tumor surgery, and 59 out of 66 cases had good bone union that is 89%. Delayed union happened in 6 cases only. Immune response to allogenic bone graft has not been found yet

Acceleration of bone union after structural bone grafts with a collagen-binding basic fibroblast growth factor anchored-collagen sheet for critical-size bone defects

International Nuclear Information System (INIS)

Ueno, Masaki; Uchida, Kentaro; Saito, Wataru; Inoue, Gen; Takahira, Naonobu; Takaso, Masashi; Matsushita, Osamu; Yogoro, Mizuki; Nishi, Nozomu; Ogura, Takayuki; Hattori, Shunji; Tanaka, Keisuke

2014-01-01

Bone allografts are commonly used for the repair of critical-size bone defects. However, the loss of cellular activity in processed grafts markedly reduces their healing potential compared with autografts. To overcome this obstacle, we developed a healing system for critical-size bone defects that consists of overlaying an implanted bone graft with a collagen sheet (CS) loaded with basic fibroblast growth factor (bFGF) fused to the collagen-binding domain derived from a Clostridium histolyticum collagenase (CB-bFGF). In a murine femoral defect model, defect sites treated with CS/CB-bFGF had a significantly larger callus volume than those treated with CS/native bFGF. In addition, treatment with CS/CB-bFGF resulted in the rapid formation of a hard callus bridge and a larger total callus volume at the host–graft junction than treatment with CS/bFGF. Our results suggest that the combined use of CS and CB-bFGF helps accelerate the union of allogenic bone grafts. (paper)

Early prophylactic autogenous bone grafting in type III open tibial fractures.

Science.gov (United States)

Kesemenli, Cumhur C; Kapukaya, Ahmet; Subaşi, Mehmet; Arslan, Huseyin; Necmioğlu, Serdar; Kayikçi, Cuma

2004-08-01

The authors report the results achieved in patients with type III open tibial fractures who underwent primary autogenous bone grafting at the time of debridement and skeletal stabilisation. Twenty patients with a mean age of 35.8 years (range, 24-55) were treated between 1996 and 1999. Eight fractures were type IIIA, 11 were type IIIB, and 1 was type IIIC. At the index procedure, wound debridement, external fixation and autogenous bone grafting with bone coverage were achieved. The mean follow-up period was 46 months (range, 34-55). The mean time to fixator removal was 21 weeks (range, 14-35), and the mean time to union was 28 weeks (range, 19-45). Skin coverage was achieved by a myocutaneous flap in 2 patients, late primary closure in 4, and split skin grafting in 14. One (5%) of the patients experienced delayed union, and 1 (5%) developed infection. In tibial type III open fractures, skin coverage may be delayed, using the surrounding soft tissue to cover any exposed bone after thorough débridement and wound cleansing. Primary prophylactic bone grafting performed at the same time reduces the rate of delayed union, shortens the time to union, and does not increase the infection rate.

Parathyroid hormone related to bone regeneration in grafted and nongrafted tooth extraction sockets in rats.

Science.gov (United States)

Kuroshima, Shinichiro; Al-Salihi, Zeina; Yamashita, Junro

2013-02-01

The quality and quantity of bone formed in tooth extraction sockets impact implant therapy. Therefore, the establishment of a new approach to enhance bone formation and to minimize bone resorption is important for the success of implant therapy. In this study, we investigated whether intermittent parathyroid hormone (PTH) therapy enhanced bone formation in grafted sockets. Tooth extractions of the maxillary first molars were performed in rats, and the sockets were grafted with xenograft. Intermittent PTH was administered either for 7 days before extractions, for 14 days after extractions, or both. The effect of PTH therapy on bone formation in the grafted sockets was assessed using microcomputed tomography at 14 days after extractions. PTH therapy for 7 days before extractions was not effective to augment bone fill, whereas PTH therapy for 14 days after operation significantly augmented bone formation in the grafted sockets. Intermittent PTH therapy starting right after tooth extractions significantly enhanced bone fill in the grafted sockets, suggesting that PTH therapy can be a strong asset for the success of the ridge preservation procedure.

Tissue reaction and material characteristics of four bone substitutes

DEFF Research Database (Denmark)

Jensen, S S; Aaboe, M; Pinholt, E M

1996-01-01

and Interpore 500 HA/CC) were implanted into 5-mm bur holes in rabbit tibiae. There was no difference in the amount of newly formed bone around the four biomaterials. Interpore 500 HA/CC resorbed completely, whereas the other three biomaterials did not undergo any detectable biodegradation. Bio......The aim of the present study was to qualitatively and quantitatively compare the tissue reactions around four different bone substitutes used in orthopedic and craniofacial surgery. Cylinders of two bovine bone substitutes (Endobon and Bio-Oss) and two coral-derived bone substitutes (Pro Osteon 500......-Oss was osseointegrated to a higher degree than the other biomaterials. Material characteristics obtained by diffuse reflectance infrared Fourier transform spectrometry analysis and energy-dispersive spectrometry did not explain the differences in biologic behavior....

Acetabular reconstruction with human and bovine freeze-dried bone grafts and a reinforcement device

Directory of Open Access Journals (Sweden)

Ricardo Rosito

2008-01-01

Full Text Available BACKGROUND: This is a cohort trial (1997-2005 of 49 patients submitted to an acetabular component revision of a total hip arthroplasty, using impacted human and bovine freeze-dried cancellous bone grafts (H&FDBG and a reinforcement device. OBJECTIVE: To compare clinical/radiographic graft incorporation capability between cancellous bone grafts. PATIENTS/METHODS: There were two groups: I (n=26 receiving human grafts and II (n=25 receiving bovine grafts. The average follow-up times were 55 and 49 months, respectively. Clinical analysis was based on the Merle d'Aubigné and Postel score, and the radiographic analysis involved an established score based on Conn's et al. criteria for radiographic bone incorporation. RESULTS: No clinical/radiographic differences were found between the groups and both showed an overall rate of 88.5% and 76% of graft incorporation (p=0.424. CONCLUSION: The results presented here are comparable to those in the literature with the use of deep-FG. Therefore, cancellous bone grafts can be safely and adequately used in acetabular component revision in total hip arthroplasty.

Bone graft healing in alveolar osteoplasty in patients with unilateral lip, alveolar process, and palate clefts.

Science.gov (United States)

Rychlik, Dariusz; Wójcicki, Piotr

2012-01-01

Secondary osteoplasty by means of autogenic spongy bone grafting is the most common procedure used in the reconstruction of the continuity of the maxillary alveolar process. The aim of the study was to analyze retrospectively the effect of certain factors on the course of the bone graft healing process in patients with unilateral complete clefts of the lip, alveolar process, and palate. The investigations involved 62 children aged 8 to 14 years (mean age, 11 years) with unilateral complete cleft of the lip, alveolar process, and palate operated on at the Clinic of Plastic Surgery in Polanica Zdrój from November 2007 to April 2009. All the procedures consisted in the reconstruction of the maxillary alveolar process by means of autogenic spongy bone grafting from the iliac bone. The analysis was performed on the basis of computed tomography scans presenting maxillary alveolar processes in the horizontal cross-sectional planes performed on the second or third postoperative day and after 6 months. They were used as the basis for the measurement of the volume and density (condensation) of the bone graft, the surface of its adhesion to the maxillary alveolar bone, and the volume and density of the healed bone. The following correlation coefficients were determined: between the adhesion surface of the bone to the alveolar bone and the volume of the healed bone, between the adhesion surface of the bone to the alveolar bone and the density of the healed bone, and between the density of the graft and the volume of the healed bone. Increasing the surface of the graft adhesion to the bone ridges of the alveolar cleft contributes to increased volume of the healed bone and slows down the increase in its density (on 6-month follow-up). Crushing of the bone graft increases its resorption and reduces volume of the healed bone.

Does Periosteal Graft Combined With Platelet-Rich Plasma Enhance the Healing of Bone Defect?

Science.gov (United States)

Türkseven, Arzu; Özçelik, Derya; Çaliş, Mert; Celik, Hakan Hamdi; Yilmaz, Fahri; Önbaş, Ömer; Vatansever, Alper; Toplu, Gaye

2018-02-12

This study investigated the effect of periosteal graft + platelet-rich plasma (PRP) combination on facial bone defect healing. Five-millimeter critical sized defects in zygomatic arches of 12 adult New Zealand rabbits were created. Rabbits were randomly divided into 3 groups: First group (control group): bone defects of left zygomatic arches of 6 rabbits were wrapped with a silicone tube. Second group (periosteal graft group): bone defects of left zygomatic arches of 6 rabbits were wrapped with periosteal graft. Third group (experimental group): bone defects of right zygomatic arches of 12 rabbits were wrapped with periosteal graft-PRP combination. New bone formation was evaluated at 8th and 16th weeks. One rabbit was sacrificed at 8th week. Remaining 11 rabbits were imaged with 3-dimensional computed tomography (CT) at 16th week; then, zygomatic arches were removed for micro-CT and histologic examinations. Three-dimensional CT analysis at 16th week revealed no significant difference between groups regarding new bone formation (P = 0.232). Micro-CT analysis of new regenerated bone at 16th week displayed significant differences between groups 1 and 3 regarding mean bone volume (BV, mm) (P = 0.028) and mean bone mineral density (BMD, mm) (P = 0.001). There was no difference between groups 2 and 3 or between groups 1 and 2, regarding BV or BMD. Histological Bone Regeneration Scorings at 16th week displayed significant difference between groups (P = 0.015). Negative correlation between 3-dimensional CT and histologic results (r = 0.120); positive correlations between BV/BMD values in micro-CT and histologic results (r = 0.524 and r = 0.456) were found. By enhancing bone formation capacity of periosteal grafts, periosteal graft-PRP combination provided bone formation having more volume and density comparing with silicone tube application.

Cartilage Morphological and Histological Findings After Reconstruction of the Glenoid With an Iliac Crest Bone Graft.

Science.gov (United States)

Auffarth, Alexander; Resch, Herbert; Matis, Nicholas; Hudelmaier, Martin; Wirth, Wolfgang; Forstner, Rosemarie; Neureiter, Daniel; Traweger, Andreas; Moroder, Philipp

2018-04-01

The J-bone graft is presumably representative of iliac crest bone grafts in general and allows anatomic glenoid reconstruction in cases of bone defects due to recurrent traumatic anterior shoulder dislocations. As a side effect, these grafts have been observed to be covered by some soft, cartilage-like tissue when arthroscopy has been indicated after such procedures. To evaluate the soft tissue covering of J-bone grafts by use of magnetic resonance imaging (MRI) and histological analysis. Case series; Level of evidence, 4. Patients underwent MRI at 1 year after the J-bone graft procedures. Radiological data were digitally processed and evaluated by segmentation of axial images. Independent from the MRI analysis, 2 biopsy specimens of J-bone grafts were harvested for descriptive histological analysis. Segmentation of the images revealed that all grafts were covered by soft tissue. This layer had an average thickness of 0.87 mm compared with 1.96 mm at the adjacent native glenoid. Of the 2 biopsy specimens, one exhibited evident hyaline-like cartilage and the other presented patches of chondrocytes embedded in a glycosaminoglycan-rich extracellular matrix. J-bone grafts are covered by soft tissue that can differentiate into fibrous and potentially hyaline cartilage. This feature may prove beneficial for delaying the onset of dislocation arthropathy of the shoulder.

Development of parietal bone surrogates for parietal graft lift training

Directory of Open Access Journals (Sweden)

Hollensteiner Marianne

2016-09-01

Full Text Available Currently the surgical training of parietal bone graft techniques is performed on patients or specimens. Commercially available bone models do not deliver realistic haptic feedback. Thus customized parietal skull surrogates were developed for surgical training purposes. Two human parietal bones were used as reference. Based on the measurement of insertion forces of drilling, milling and saw procedures suitable material compositions for molding cortical and cancellous calvarial layers were found. Artificial skull caps were manufactured and tested. Additionally microtomograpy images of human and artificial parietal bones were performed to analyze outer table and diploe thicknesses. Significant differences between human and artificial skulls were not detected with the mechanical procedures tested. Highly significant differences were found for the diploe thickness values. In conclusion, an artificial bone has been created, mimicking the properties of human parietal bone thus being suitable for tabula externa graft lift training.

Bone replacement following dental trauma prior to implant surgery - present status

NARCIS (Netherlands)

Hallman, Mats; Mordenfeld, Arne; Strandkvist, Tomas

Dento-alveolar trauma often leads to a need for reconstruction of the alveolar crest before an implant can be placed. Although autogenous bone grafts is considered the 'gold standard', this may be associated with patient morbidity and graft resorption. Consequently, the use of bone substitutes has

Successful disinfection of femoral head bone graft using high hydrostatic pressure.

Science.gov (United States)

van de Sande, Michiel A J; Bovée, Judith V M G; van Domselaar, Mark; van Wijk, Marja J; Sanders, Ingrid; Kuijper, Ed

2017-12-20

The current standard for sterilization of potentially infected bone graft by gamma irradiation and thermal or chemical inactivation potentially deteriorates the biomechanical properties of the graft. We performed an in vitro experiment to evaluate the use of high hydrostatic pressure (HHP); which is widely used as a disinfection process in the food processing industry, to sterilize bone grafts. Four femoral heads were divided into five parts each, of which 16 were contaminated (in duplicate) with 10 5 -10 7  CFU/ml of Staphylococcus epidermidis, Bacillus cereus, or Pseudomonas aeruginosa or Candida albicans, respectively. Of each duplicate, one sample was untreated and stored similarly as the treated sample. The remaining four parts were included as sterile control and non-infected control. The 16 parts underwent HHP at the high-pressure value of 600 MPa. After HHP, serial dilutions were made and cultured on selective media and into enrichment media to recover low amounts of microorganism and spores. Three additional complete femoral heads were treated with 0, 300 and 600 MPa HHP respectively for histological evaluation. None of the negative-control bone fragments contained microorganisms. The measured colony counts in the positive-control samples correlated excellent with the expected colony count. None of the HHP treated bone fragments grew on culture plates or enrichment media. Histological examination of three untreated femoral heads showed that the bone structure remained unchanged after HHP. Sterilizing bone grafts by high hydrostatic pressure was successful and is a promising technique with the possible advantage of retaining biomechanical properties of bone tissue.

Histological evaluation of the influence of magnetic field application in autogenous bone grafts in rats

Directory of Open Access Journals (Sweden)

Ponzoni Deise

2009-01-01

Full Text Available Abstract Background Bone grafts are widely used in oral and maxillofacial reconstruction. The influence of electromagnetic fields and magnets on the endogenous stimulation of target tissues has been investigated. This work aimed to assess the quality of bone healing in surgical cavities filled with autogenous bone grafts, under the influence of a permanent magnetic field produced by in vivo buried devices. Methods Metal devices consisting of commercially pure martensitic stainless steel washers and titanium screws were employed. Thirty male Wistar rats were divided into 3 experimental and 3 control groups. A surgical bone cavity was produced on the right femur, and a bone graft was collected and placed in each hole. Two metallic washers, magnetized in the experimental group but not in the control group, were attached on the borders of the cavity. Results The animals were sacrificed on postoperative days 15, 45 and 60. The histological analysis of control and experimental samples showed adequate integration of the bone grafts, with intense bone neoformation. On days 45 and 60, a continued influence of the magnetic field on the surgical cavity and on the bone graft was observed in samples from the experimental group. Conclusion The results showed intense bone neoformation in the experimental group as compared to control animals. The intense extra-cortical bone neoformation observed suggests that the osteoconductor condition of the graft may be more susceptible to stimulation, when submitted to a magnetic field.

Ilizarov bone transport versus fibular graft for reconstruction of tibial bone defects in children.

Science.gov (United States)

Abdelkhalek, Mostafa; El-Alfy, Barakat; Ali, Ayman M

2016-11-01

The aim of this study was to compare the results of treatment of segmental tibial defects in the pediatric age group using an Ilizarov external fixator versus a nonvascularized fibular bone graft. This study included 24 patients (age range from 5.5 to 15 years) with tibial bone defects: 13 patients were treated with bone transport (BT) and 11 patients were treated with a nonvascularized fibular graft (FG). The outcome parameters were bone results (union, deformity, infection, leg-length discrepancy) and functional results: external fixation index and external fixation time. In group A (BT), one patient developed refracture at the regenerate site, whereas, in group B (FG), after removal of the external fixator, one of the FGs developed a stress fracture. The external fixator time in group A was 10.7 months (range 8-14.5) versus 7.8 months (range 4-11.5 months) in group B (FG). In group A (BT), one patient had a limb-length discrepancy (LLD), whereas, in group B (FG), three patients had LLD. The functional and bone results of the Ilizarov BT technique were excellent in 23.1 and 30.8%, good in 38.5 and 46.2, fair in 30.8 and 15.4, and poor in 7.6 and 7.6%, respectively. The poor functional result was related to the poor bone result because of prolonged external fixator time resulting in significant pain, limited ankle motion, whereas the functional and bone results of fibular grafting were excellent in 9.1 and 18.2%, good in 63.6 and 45.5%, fair in 18.2 and 27.2%, and poor in 9.1 and 9.1%, respectively. Segmental tibial defects can be effectively treated with both methods. The FG method provides satisfactory results, with early removal of the external fixator. However, it had a limitation in patients with severe infection and those with LLD. Also, it requires a long duration of limb bracing until adequate hypertrophy of the graft. The Ilizarov method has the advantages of early weight bearing, treatment of postinfection bone defect in a one-stage surgery, and the

[Bone graft reconstruction for posterior mandibular segment using the formwork technique].

Science.gov (United States)

Pascual, D; Roig, R; Chossegros, C

2014-04-01

Pre-implant bone graft in posterior mandibular segments is difficult because of masticatory and lingual mechanical constraints, because of the limited bone vascularization, and because of the difficulty to cover it with the mucosa. The formwork technique is especially well adapted to this topography. The recipient site is abraded with a drill. Grooves are created to receive and stabilize the grafts. The bone grafts were harvested from the ramus. The thinned cortices are assembled in a formwork and synthesized by mini-plates. The gaps are filled by bone powder collected during bone harvesting. The bone volume reconstructed with the formwork technique allows anchoring implants more than 8mm long. The proximity of the inferior alveolar nerve does not contra indicate this technique. The formwork size and its positioning on the alveolar crest can be adapted to prosthetic requirements by using osteosynthesis plates. The lateral implant walls are supported by the formwork cortices; the implant apex is anchored on the native alveolar crest. The primary stability of implants is high, and the torque is important. The ramus harvesting decreases operative risks. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Defect nonunion of a metatarsal bone fracture in a cow: successful management with bone plating and autogenous cancellous bone graft.

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Raghunath, M; Singh, N; Singh, T; Gopinathan, A; Mohindroo, J; Atri, K

2013-01-01

A two-and-half-year-old cow was presented with a defect nonunion of the right metatarsal III/IV bone following a severely comminuted open fracture two months previously. The animal underwent open fixation using a 4.5 mm, broad, 10-hole, dynamic compression plate and autogenous cancellous bone graft collected from the contralateral iliac shaft. The animal started partial weight bearing after the third postoperative day and resumed complete weight bearing after the 10th day. Fracture healing was complete and the implants were removed after the 120th postoperative day. Stable fixation by means of a bone plate in conjunction with a cancellous bone graft facilitated complete healing and restoration of the bone column of the defect and the metatarsal fracture. The animal made a complete recovery.

Histologic Evaluation of Critical Size Defect Healing With Natural and Synthetic Bone Grafts in the Pigeon ( Columba livia ) Ulna.

Science.gov (United States)

Tunio, Ahmed; Jalila, Abu; Goh, Yong Meng; Shameha-Intan; Shanthi, Ganabadi

2015-06-01

Fracture and bone segment loss are major clinical problems in birds. Achieving bone formation and clinical union in a fracture case is important for the survival of the bird. To evaluate the efficacy of bone grafts for defect healing in birds, 2 different bone grafts were investigated in the healing of a bone defect in 24 healthy pigeons ( Columba livia ). In each bird, a 1-cm critical size defect (CSD) was created in the left ulna, and the fracture was stabilized with external skeletal fixation (ESF). A graft of hydroxyapatite (HA) alone (n = 12 birds) or demineralized bone matrix (DBM) combined with HA (n = 12 birds) was implanted in the CSD. The CSD healing was evaluated at 3 endpoints: 3, 6, and 12 weeks after surgery. Four birds were euthanatized at each endpoint from each treatment group, and bone graft healing in the ulna CSD was evaluated by histologic examination. The CSD and graft implants were evaluated for quality of union, cortex development, and bone graft incorporation. Results showed no graft rejection in any bird, and all birds had connective tissue formation in the defect because of the bone graft application. These results suggest that bone defect healing can be achieved by a combination of osteoinductive and osteoconductive bone graft materials for clinical union and new bone regeneration in birds. The combination of DBM and HA resulted in a better quality bone graft (P < .05) than did HA alone, but there was no significant differences in cortex development or bone graft incorporation at 3, 6, or 12 weeks. From the results of this study, we conclude that HA bone grafts, alone or in combination with DBM, with external skeletal fixation is suitable and safe for bone defect and fracture treatment in pigeons.

Management of compromised anterior maxillary edentulous arch with symphyseal bone graft

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Sunil Kumar Mishra

2018-01-01

Full Text Available Achieving optimal aesthetics, function and phonetics with implant-supported restorations depends largely on the amount of bone present at the site where implant has to be placed. Sometimes, patient reports with compromised conditions which makes the implant placement difficult. Today, reconstruction procedures such as autogenous bone graft and guided bone regeneration make the implant placement possible in different ridge deficient cases. This case report describes step-by-step procedure of restoring the missing maxillary right central incisor with implant-supported prostheses. In missing left central incisor region, the alveolar bony defect was corrected by autogenous bone graft obtained from symphysis region, for restoration with implant prostheses.

Fate of bulk auto grafts in uncemented total hip arthroplasty: Evaluation by bone scintigraphy

International Nuclear Information System (INIS)

Simsek, A.; Cila, E.; Sener, E.; Senkoylu, A.; Sipahioglu, S.; Atasever, T.; Akdemir, Ozgur

2006-01-01

Objective was to review short term results of uncemented cup implantation and the fate of bulk femoral head autografts in patients with acetabular bone deficiency due to dysplasia of the hip. We used bone scintigraphy to assess the viability of the grafts. We treated 19 hip joints of 17 patients with osteoarthritis due to developmental dysplasia of the hip with uncemented total hip arthroplasty between 1997-2003 in the Department of Orthopedics and Traumatology, Gazi University, Ankara, Turkey. The average age was 49.1 (31-72 years), and the average follow up period was 36 months. We used femoral head autografts to reconstruct superolateral segmental deficiencies of the acetabuli. We evaluated the patients clinically and radiologically to assess acetabular loosening, and we used three-phase bone scintigraphy to evaluate the viability of the autograft.There was no acetabular component revision throughout the follow up period. There was no radiological evidence of graft resorption or graft displacement in any of the patients. In bone scintigraphy, we observed hyperemia in the blood pool phase, and the osteoblastic activity of the bone graft was at the level of the neighboring iliac bone. The application of a non-cemented acetabular component with femoral autograft in superolateral acetabulum deficiency increases the stability of the implant and increases the bone stock. It is not easy to evaluate the viability of the graft by the use of radiological methods. Bone scintigraphy gives sufficient information about the viability of the graft as a non-invasive method. (author)

Autogenous Partial Bone Chip Grafting on the Exposed Inferior Alveolar Nerve After Cystic Enucleation.

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Seo, Mi Hyun; Eo, Mi Young; Cho, Yun Ju; Kim, Soung Min; Lee, Suk Keun

2018-03-01

This prospective study evaluated the clinical effectiveness of the new approach of partial autogenous bone chip grafts for the treatment of mandibular cystic lesions related to the inferior alveolar nerve (IAN). A total of 38 patients treated for mandibular cysts or benign tumors were included in this prospective study and subsequently divided into 3 groups depending on the bone grafting method used: cystic enucleation without a bone graft (group 1), partial bone chip graft covering the exposed IAN (group 2), and autogenous bone graft covering the entire defect (group 3). We evaluated the symptoms, clinical signs, and radiographic changes using dental panorama preoperatively, immediate postoperatively, and at 1, 3, 6, and 12 months postoperatively. Radiographic densities were compared using Adobe Photoshop CS5 (Adobe Systems Inc., San Jose, CA). Repeated measures analysis of variance was used for statistical evaluation with SPSS 22.0 (SPSS Inc, Chicago, IL), and P < 0.05 was considered statistically significant.Radiopacities were the most increased at 1 year postoperative in group 3; groups 2 and 3 did not show statistically significant differences, whereas groups 1 and 3 were statistically significant. In terms of radiographic bone healing with clinical regeneration of the exposed IAN, healing occurred in all patients, although the best healing was achieved in group 2.This autogenous partial bone chip grafting procedure to cover the exposed IAN is suggested as a new surgical protocol for the treatment of cystic lesions associated with the IAN.

Decellularization and Delipidation Protocols of Bovine Bone and Pericardium for Bone Grafting and Guided Bone Regeneration Procedures.

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Chiara Gardin

Full Text Available The combination of bone grafting materials with guided bone regeneration (GBR membranes seems to provide promising results to restore bone defects in dental clinical practice. In the first part of this work, a novel protocol for decellularization and delipidation of bovine bone, based on multiple steps of thermal shock, washes with detergent and dehydration with alcohol, is described. This protocol is more effective in removal of cellular materials, and shows superior biocompatibility compared to other three methods tested in this study. Furthermore, histological and morphological analyses confirm the maintenance of an intact bone extracellular matrix (ECM. In vitro and in vivo experiments evidence osteoinductive and osteoconductive properties of the produced scaffold, respectively. In the second part of this study, two methods of bovine pericardium decellularization are compared. The osmotic shock-based protocol gives better results in terms of removal of cell components, biocompatibility, maintenance of native ECM structure, and host tissue reaction, in respect to the freeze/thaw method. Overall, the results of this study demonstrate the characterization of a novel protocol for the decellularization of bovine bone to be used as bone graft, and the acquisition of a method to produce a pericardium membrane suitable for GBR applications.

Injectable biphasic calcium phosphate cements as a potential bone substitute

NARCIS (Netherlands)

Sariibrahimoglu, K.; Wolke, J.G.C.; Leeuwenburgh, S.C.G.; Yubao, L.; Jansen, J.A.

2014-01-01

Apatitic calcium phosphate cements (CPCs) have been widely used as bone grafts due to their excellent osteoconductive properties, but the degradation properties are insufficient to stimulate bone healing in large bone defects. A novel approach to overcome the lack of degradability of apatitic CPC

Use of lymphokine-activated killer cells to prevent bone marrow graft rejection and lethal graft-vs-host disease

International Nuclear Information System (INIS)

Azuma, E.; Yamamoto, H.; Kaplan, J.

1989-01-01

Prompted by our recent finding that lymphokine-activated killer (LAK) cells mediate both veto and natural suppression, we tested the ability of adoptively transferred LAK cells to block two in vivo alloreactions which complicate bone marrow transplantation: resistance to transplanted allogeneic bone marrow cells, and lethal graft-vs-host disease. Adoptive transfer of either donor type B6D2 or recipient-type B6 lymphokine-activated bone marrow cells, cells found to have strong LAK activity, abrogated or inhibited the resistance of irradiated B6 mice to both B6D2 marrow and third party-unrelated C3H marrow as measured by CFU in spleen on day 7. The ability of lymphokine-activated bone marrow cells to abrogate allogeneic resistance was eliminated by C lysis depletion of cells expressing asialo-GM1, NK1.1, and, to a variable degree, Thy-1, but not by depletion of cells expressing Lyt-2, indicating that the responsible cells had a LAK cell phenotype. Similar findings were obtained by using splenic LAK cells generated by 3 to 7 days of culture with rIL-2. Demonstration that allogeneic resistance could be blocked by a cloned LAK cell line provided direct evidence that LAK cells inhibit allogeneic resistance. In addition to inhibiting allogeneic resistance, adoptively transferred recipient-type LAK cells prevented lethal graft-vs-host disease, and permitted long term engraftment of allogeneic marrow. Irradiation prevented LAK cell inhibition of both allogeneic resistance and lethal graft-vs-host disease. These findings suggest that adoptive immunotherapy with LAK cells may prove useful in preventing graft rejection and graft-versus-host disease in human bone marrow transplant recipients

Combination of calcium sulfate and simvastatin-controlled release microspheres enhances bone repair in critical-sized rat calvarial bone defects

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Fu YC

2015-12-01

Full Text Available Yin-Chih Fu,1–4 Yan-Hsiung Wang,1,5 Chung-Hwan Chen,1,3,4 Chih-Kuang Wang,1,6 Gwo-Jaw Wang,1,3,4 Mei-Ling Ho1,3,7,8 1Orthopaedic Research Center, 2Graduate Institute of Medicine, 3Department of Orthopaedics, 4Department of Orthopaedics, College of Medicine, 5School of Dentistry, College of Dental Medicine, 6Department of Medicinal and Applied Chemistry, 7Department of Physiology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; 8Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, TaiwanAbstract: Most allogenic bone graft substitutes have only osteoconductive properties. Developing new strategies to improve the osteoinductive activity of bone graft substitutes is both critical and practical for clinical application. Previously, we developed novel simvastatin-encapsulating poly(lactic-co-glycolic acid microspheres (SIM/PLGA that slowly release simvastatin and enhance fracture healing. In this study, we combined SIM/PLGA with a rapidly absorbable calcium sulfate (CS bone substitute and studied the effect on bone healing in critical-sized calvarial bone defects in a rat model. The cytotoxicity and cytocompatibility of this combination was tested in vitro using lactate dehydrogenase leakage and a cell attachment assay, respectively. Combination treatment with SIM/PLGA and the CS bone substitute had no cytotoxic effect on bone marrow stem cells. Compared with the control, cell adhesion was substantially enhanced following combination treatment with SIM/PLGA and the CS bone substitute. In vivo, implantation of the combination bone substitute promoted healing of critical-sized calvarial bone defects in rats; furthermore, production of bone morphogenetic protein-2 and neovascularization were enhanced in the area of the defect. In summary, the combination of SIM/PLGA and a CS bone substitute has osteoconductive and osteoinductive properties, indicating that it could be used for regeneration

3D-Printed Scaffolds and Biomaterials: Review of Alveolar Bone Augmentation and Periodontal Regeneration Applications

Science.gov (United States)

Asa'ad, Farah; Giannì, Aldo Bruno; Giannobile, William V.; Rasperini, Giulio

2016-01-01

To ensure a successful dental implant therapy, the presence of adequate vertical and horizontal alveolar bone is fundamental. However, an insufficient amount of alveolar ridge in both dimensions is often encountered in dental practice due to the consequences of oral diseases and tooth loss. Although postextraction socket preservation has been adopted to lessen the need for such invasive approaches, it utilizes bone grafting materials, which have limitations that could negatively affect the quality of bone formation. To overcome the drawbacks of routinely employed grafting materials, bone graft substitutes such as 3D scaffolds have been recently investigated in the dental field. In this review, we highlight different biomaterials suitable for 3D scaffold fabrication, with a focus on “3D-printed” ones as bone graft substitutes that might be convenient for various applications related to implant therapy. We also briefly discuss their possible adoption for periodontal regeneration. PMID:27366149

3D-Printed Scaffolds and Biomaterials: Review of Alveolar Bone Augmentation and Periodontal Regeneration Applications

Directory of Open Access Journals (Sweden)

Farah Asa’ad

2016-01-01

Full Text Available To ensure a successful dental implant therapy, the presence of adequate vertical and horizontal alveolar bone is fundamental. However, an insufficient amount of alveolar ridge in both dimensions is often encountered in dental practice due to the consequences of oral diseases and tooth loss. Although postextraction socket preservation has been adopted to lessen the need for such invasive approaches, it utilizes bone grafting materials, which have limitations that could negatively affect the quality of bone formation. To overcome the drawbacks of routinely employed grafting materials, bone graft substitutes such as 3D scaffolds have been recently investigated in the dental field. In this review, we highlight different biomaterials suitable for 3D scaffold fabrication, with a focus on “3D-printed” ones as bone graft substitutes that might be convenient for various applications related to implant therapy. We also briefly discuss their possible adoption for periodontal regeneration.

[Current treatment situation and progress on bone defect of collapsed tibial plateau fractures].

Science.gov (United States)

Luo, Chang-qi; Fang, Yue; Tu, Chong-qi; Yang, Tian-fu

2016-02-01

Characteristics of collapsed tibial plateau fracture determines that the joint surface must remain anatomical reduction,line of force in tibial must exist and internal fixation must be strong. However, while renewing articular surface smoothness, surgeons have a lot of problems in dealing with bone defect under the joint surface. Current materials used for bone defect treatment include three categories: autologous bone, allograft bone and bone substitutes. Some scholars think that autologous bone grafts have a number of drawbacks, such as increasing trauma, prolonged operation time, the limited source, bone area bleeding,continuous pain, local infection and anesthesia,but most scholars believe that the autologous cancellous bone graft is still the golden standard. Allograft bone has the ability of bone conduction, but the existence of immune responses, the possibility of a virus infection, and the limited source of the allograft cannot meet the clinical demands. Likewise, bone substitutes have the problem that osteogenesis does not match with degradation in rates. Clinical doctors can meet the demand of the patient's bone graft according to patient's own situation and economic conditions.

Physicochemical characterization of porcine bone-derived grafting material and comparison with bovine xenografts for dental applications.

Science.gov (United States)

Lee, Jung Heon; Yi, Gyu Sung; Lee, Jin Woong; Kim, Deug Joong

2017-12-01

The physicochemical properties of a xenograft are very important because they strongly influence the bone regeneration capabilities of the graft material. Even though porcine xenografts have many advantages, only a few porcine xenografts are commercially available, and most of their physicochemical characteristics have yet to be reported. Thus, in this work we aimed to investigate the physicochemical characteristics of a porcine bone grafting material and compare them with those of 2 commercially available bovine xenografts to assess the potential of xenogenic porcine bone graft materials for dental applications. We used various characterization techniques, such as scanning electron microscopy, the Brunauer-Emmett-Teller adsorption method, atomic force microscopy, Fourier-transform infrared spectroscopy, X-ray diffraction, and others, to compare the physicochemical properties of xenografts of different origins. The porcine bone grafting material had relatively high porosity (78.4%) and a large average specific surface area (SSA; 69.9 m 2 /g), with high surface roughness (10-point average roughness, 4.47 µm) and sub-100-nm hydroxyapatite crystals on the surface. Moreover, this material presented a significant fraction of sub-100-nm pores, with negligible amounts of residual organic substances. Apart from some minor differences, the overall characteristics of the porcine bone grafting material were very similar to those of one of the bovine bone grafting material. However, many of these morphostructural properties were significantly different from the other bovine bone grafting material, which exhibited relatively smooth surface morphology with a porosity of 62.0% and an average SSA of 0.5 m 2 /g. Considering that both bovine bone grafting materials have been successfully used in oral surgery applications in the last few decades, this work shows that the porcine-derived grafting material possesses most of the key physiochemical characteristics required for its

Stress fracture as a complication of autogenous bone graft harvest from the distal tibia.

Science.gov (United States)

Chou, Loretta B; Mann, Roger A; Coughlin, Michael J; McPeake, William T; Mizel, Mark S

2007-02-01

Autogenous bone graft from the distal tibia provides cancellous bone graft for foot and ankle operations, and it has osteogenic and osteoconductive properties. The site is in close proximity to the foot and ankle, and published retrospective studies show low morbidity from the procedure. One-hundred autografts were obtained from the distal tibia between 2000 and 2003. In four cases the distal tibial bone graft harvest resulted in a stress fracture. There were three women and one man. The average time of diagnosis of the stress fracture from the operation was 1.8 months. All stress fractures healed with a short course (average 2.4 months) of cast immobilization. This study demonstrated that a stress fracture from the donor site of autogenous bone graft of the distal tibia occurs and can be successfully treated nonoperatively.

Computed tomography to evaluate the association of fragmented heterolog cortical bone and methylmethacrylate to repare segmental bone defect produced in tibia of rabbits

International Nuclear Information System (INIS)

Freitas, S.H.; Doria, R.G.S.; Mendonca, F.S.; Santos, M.D.; Moreira, R.; Simoes, R.S.; Camargo, L.M.; Simoes, M.J.; Marques, A.T.C.

2012-01-01

A 6mm segmental defect was performed on the metaphyseal region of the tibia of 12 rabbits and the autoclaved fragmented heterolog cortical bone conserved in glycerin (98%) and methylmethacrylate was used as a bone graft for the reconstruction. The graft was placed in the receptor bed and its integration was evaluated by computed tomography after 30, 60 and 90 days. There was gradual bone graft incorporation in the receptor bed during the time in 100% of the cases. Fragmented cortical bone heterograft and methylmethacrylate was biologically compatible and promotes bone defect reparation without signs of infection, migration and or rejection, featuring a new option of osseous substitute to fill in bone defects. (author)

Hydrogel/bioactive glass composites for bone regeneration applications: Synthesis and characterisation

International Nuclear Information System (INIS)

Killion, John A.; Kehoe, Sharon; Geever, Luke M.; Devine, Declan M.; Sheehan, Eoin; Boyd, Daniel; Higginbotham, Clement L.

2013-01-01

Due to the deficiencies of current commercially available biological bone grafts, alternative bone graft substitutes have come to the forefront of tissue engineering in recent times. The main challenge for scientists in manufacturing bone graft substitutes is to obtain a scaffold that has sufficient mechanical strength and bioactive properties to promote formation of new tissue. The ability to synthesise hydrogel based composite scaffolds using photopolymerisation has been demonstrated in this study. The prepared hydrogel based composites were characterised using techniques including Fourier Transform Infrared Spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), Energy-dispersive X-ray spectrometry (EDX), rheological studies and compression testing. In addition, gel fraction, differential scanning calorimetry (DSC), thermogravimetric analysis (TGA), porosity and swelling studies of the composites were carried out. It was found that these novel hydrogel bioglass composite formulations did not display the inherent brittleness that is typically associated with bioactive glass based bone graft materials and exhibited enhanced biomechanical properties compared to the polyethylene glycol hydrogel scaffolds along. Together, the combination of enhanced mechanical properties and the deposition of apatite on the surface of these hydrogel based composites make them an ideal candidate as bone graft substitutes in cancellous bone defects or low load bearing applications. Highlights: • Young's modulus increases with the addition of bioactive glasses. • Hydrogel based composites formed an apatite layer in simulated body fluid. • Storage modulus increases with addition of bioactive glasses. • Compressive strength is dependent on molecular weight and bioactive glass loading

Composite coating of 58S bioglass and hydroxyapatite on a poly (ethylene terepthalate) artificial ligament graft for the graft osseointegration in a bone tunnel

Energy Technology Data Exchange (ETDEWEB)

Li Hong; Wu Yang; Ge Yunsheng; Jiang Jia; Gao Kai [Department of Sports Medicine, Huashan Hospital, Shanghai (China); Zhang Pengyun; Wu Lingxiang [Shanghai Research Center of Biomedical Engineering, Shanghai (China); Chen Shiyi, E-mail: cshiyi@163.com [Department of Sports Medicine, Huashan Hospital, Shanghai (China)

2011-09-01

The purpose of this study was to determine the effect of the combination of hydroxyapatite (HA) and bioglass (BG) on polyethylene terephthalate (PET) artificial ligament graft osseointegration within the bone tunnel. The results of in vitro culturing of MC3T3-E1 mouse osteoblastic cells proved that this HA/BG composite coating can promote the cell compatibility of grafts. A rabbit extraarticular tendon-to-bone healing model was used to evaluate the effect of this composite coating on PET artificial ligaments in vivo. The final results demonstrated that HA/BG coating improved new bone formation at the graft-bone interface and increased the load-to-failure property of graft in bone tunnel compared to the control group at early time. The study has shown that HA/BG composite coating on the PET artificial ligament surface has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel.

Composite coating of 58S bioglass and hydroxyapatite on a poly (ethylene terepthalate) artificial ligament graft for the graft osseointegration in a bone tunnel

International Nuclear Information System (INIS)

Li Hong; Wu Yang; Ge Yunsheng; Jiang Jia; Gao Kai; Zhang Pengyun; Wu Lingxiang; Chen Shiyi

2011-01-01

The purpose of this study was to determine the effect of the combination of hydroxyapatite (HA) and bioglass (BG) on polyethylene terephthalate (PET) artificial ligament graft osseointegration within the bone tunnel. The results of in vitro culturing of MC3T3-E1 mouse osteoblastic cells proved that this HA/BG composite coating can promote the cell compatibility of grafts. A rabbit extraarticular tendon-to-bone healing model was used to evaluate the effect of this composite coating on PET artificial ligaments in vivo. The final results demonstrated that HA/BG coating improved new bone formation at the graft-bone interface and increased the load-to-failure property of graft in bone tunnel compared to the control group at early time. The study has shown that HA/BG composite coating on the PET artificial ligament surface has a positive effect in the induction of artificial ligament osseointegration within the bone tunnel.

Vancomycin graft composite for infected bone defects

International Nuclear Information System (INIS)

Winkler, H.; Janata, O.; Georgopoulos, A.

1999-01-01

Reconstructive surgery under septic conditions represents a major challenge in orthopaedics. Local application of antibiotics can provide high drug levels at the site of infection without systemic effects. However, removal of non-resorbable implants and filling of defects usually requires additional operative procedures. An ideal antibiotic carrier should provide for : 1) Effective bactericidal activity, especially against staphylococci including MRSA; 2) High and long lasting levels at the site of infection without local or systemic toxicity; 3) Repair of defects without a second stage procedure. Allogeneic cancellous bone is proven to be effective in restoration of bone stock. Vancomycin is effective against all gram-positive populations and the agent of choice for infections with MRSA. The aim of our study is to investigate the efficacy of a combination of both components in bone infection. Cancellous bone of human origin was processed during several steps and incubated in 10% vancomycin solution. The antimicrobial activity of the vancomycin graft composite (VGC) was evaluated using an agar diffusion bioassay against staphylococcus aureus and high performance liquid chromatography (HPLC). The testing period was up to 9 weeks. Elution of vancomycin from the graft was evaluated in 2.5% human albumin solution, which was exchanged every 24 hours. Concentration of vancomycin in allograft-bone was between 6.653[tg/g and 23.194gg/g with an average of 15.250 [tg/g, which is equivalent to 10.000 times the minimum inhibitory concentration (MIC) for s. aureus. The initial activity decreased to approx. 50% during the first week and approx. 30% at the end of the 9th week. The lowest values measured exceeded the MIC by 2000 times. Concentration in surrounding fluid decreased from 24.395,80 to 18,43pg/ml after 11 complete exchanges. Human cancellous bone, processed in an adequate way, offers capability to store high quantities of vancomycin. Vancomycin graft composites are

Internal fixation and muscle pedicle bone grafting in femoral neck fractures

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Gupta A

2008-01-01

Full Text Available Background: The treatment of displaced intracapsular femoral neck fracture is still an unsolved problem. Non-union and avascular necrosis are the two main complications of this fracture, especially if patient presents late. Muscle pedicle bone grafting has been advocated to provide additional blood supply. We present analysis of our 32 cases of displaced femoral neck fracture treated by internal fixation and quadratus femoris based muscle pedicle bone grafting. Materials and Methods: Open reduction and internal fixation with muscle pedicle grafting was done in 32 patients. The age of patients varied from 14-62 years (average age 45 years with male to female ratio of 13:3. Twenty-nine fractures were more than three weeks old. All the cases were treated by Meyers′ procedure. The fracture was internally fixed after open reduction and then a muscle pedicle graft was applied. It was supplemented by cancellous bone graft in seven cases. Fixation was done by parallel cancellous lag screws ( n = 19, crossed Garden′s screws ( n = 7, parallel Asnis screws ( n = 5 and Moore′s pin ( n = 1.Quadratus femoris muscle pedicle graft was used in 32 cases. In the initial 12 cases the graft was fixed with circumferential proline sutures, but later, to provide a secure fixation, the graft was fixed with a cancellous screw ( n = 20. Postoperative full weight bearing was deferred to an average of 10 weeks. Results: Union was achieved in 26/29 (89.65% cases which could be followed for an average period of 3.4 years, (2-8.5 years with good functional results and had the ability to squat and sit cross-legged. Results were based on hip rating system given by Salvatti and Wilson. The results were excellent in 15 cases, good in four cases, fair in four cases and poor in six cases. Complications were avascular necrosis ( n = 2, transient foot drop ( n = 2, coxa-vara ( n = 1 and temporary loss of scrotal sensation ( n = 1. Conclusion: Muscle pedicle bone grafting with

Proximal Tibia Bone Graft: An alternative Donor Source especially for Foot and Ankle Procedures

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Jia TY

2015-03-01

Full Text Available Among the many donor sites for harvesting autologous bone graft, the iliac crest has been the most commonly used. However, for foot and ankle procedures the proximal tibia has gained popularity as an alternative donor site due to its anatomic proximity to the primary surgical site. In this article we evaluated the possible complications associated with harvesting proximal tibia bone graft. Our study showed the low incidence of morbidity in harvesting proximal tibia bone graft, thereby providing a good alternative donor for foot and ankle procedures.

New nano-hydroxyapatite in bone defect regeneration: A histological study in rats.

Science.gov (United States)

Kubasiewicz-Ross, Paweł; Hadzik, Jakub; Seeliger, Julia; Kozak, Karol; Jurczyszyn, Kamil; Gerber, Hanna; Dominiak, Marzena; Kunert-Keil, Christiane

2017-09-01

Many types of bone substitute materials are available on the market. Researchers are refining new bone substitutes to make them comparable to autologous grafting materials in treatment of bone defects. The purpose of the study was to evaluate the osseoconductive potential and bone defect regeneration in rat calvaria bone defects treated with new synthetic nano-hydroxyapatite. The study was performed on 30 rats divided into 5 equal groups. New preproduction of experimental nano-hydroxyapatite material by NanoSynHap (Poznań, Poland) was tested and compared with commercially available materials. Five mm critical size defects were created and filled with the following bone grafting materials: 1) Geistlich Bio-Oss ® ; 2) nano-hydroxyapatite+β-TCP; 3) nano-hydroxyapatite; 4) nano-hydroxyapatite+collagen membrane. The last group served as controls without any augmentation. Bone samples from calvaria were harvested for histological and micro-ct evaluation after 8 weeks. New bone formation was observed in all groups. Histomorphometric analysis revealed an amount of regenerated bone between 34.2 and 44.4% in treated bone defects, whereas only 13.0% regenerated bone was found in controls. Interestingly, in group 3, no significant particles of the nano-HA material were found. In contrast, residual bone substitute material could be detected in all other test groups. Micro-CT study confirmed the results of the histological examinations. The new nano-hydroxyapatite provides comparable results to other grafts in the field of bone regeneration. Copyright © 2017 Elsevier GmbH. All rights reserved.

In Situ Splitting of a Rib Bone Graft for Reconstruction of Orbital Floor and Medial Wall.

Science.gov (United States)

Uemura, Tetsuji; Yanai, Tetsu; Yasuta, Masato; Harada, Yoshimi; Morikawa, Aya; Watanabe, Hidetaka; Kurokawa, Masato

2017-06-01

In situ splitting of rib bone graft was conducted in 22 patients for the repair of orbital fracture with no other complicating fractures. A bone graft was harvested from the sixth or seventh rib in the right side. The repair of the orbital floor and medial wall was successful in all the cases. Ten patients had bone grafting to the orbital floor, eight had it done onto medial wall, and 4 onto both floor and wall after reduction. The mean length of in situ rib bone graft was 40.9 mm (range, 20-70 mm), the mean width of these was 14.9 mm (range, 8-20 mm). The bone grafting was done by one leaf for 15 cases and two leafs for 7 cases in size of defects. The technique of in situ splitting of a rib bone graft for the repair of the orbital floor and medial wall is a simple and safe procedure, easily taking out the in situ splitting of a rib, and less pain in donor site. It has proved to be an optimal choice in craniofacial reconstruction, especially the defects of orbital floor and medial wall.

A case of monostotic fibrous dysplasia of proximal femur managed with curettage and cortical bone grafting

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A D Sud

2013-01-01

Full Text Available We present a case report of a young military personnel with monostotic fibrous dysplasia of proximal femur with painful, dysplasticlesion of the femoral neck and fatigue fracture who underwent cortical bone grafting using autogenous fibular strut graft and iliac crest bone graft. The fibular cortical grafts was used to bridge the lesion in the femoral neck and were securely anchored to the normal bone of the lateral femoral cortex and a head of the femur. No supplemental internal fixation was required.

Three-Dimensional Finite Element Analysis of Maxillary Sinus Floor Augmentation with Optimal Positioning of a Bone Graft Block

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Peter Schuller-Götzburg

2018-01-01

Full Text Available Purpose: the aim of the computational 3D-finite element study is to evaluate the influence of an augmented sinus lift with additional inserted bone grafting. The bone graft block stabilizes the implant in conjunction with conventional bone augmentation. Two finite element models were applied: the real geometry based bone models and the simplified geometry models. The bone graft block was placed in three different positions. The implants were loaded first with an axial force and then with forces simulating laterotrusion and protrusion. This study examines whether the calculated stress behavior is symmetrical for both models. Having established a symmetry between the primary axis, the laterotrusion and protrusion behavior reduces calculation efforts, by simplifying the model. Material and Methods: a simplified U-shaped 3D finite element model of the molar region of the upper jaw and a more complex anatomical model of the left maxilla with less cortical bone were created. The bone graft block was placed in the maxillary sinus. Then the von Mises stress distribution was calculated and analyzed at three block positions: at contact with the sinus floor, in the middle of the implant helix and in the upper third of the implant. The two finite element models were then compared to simplify the modelling. Results: the position of the bone graft block significantly influences the magnitude of stress distribution. A bone graft block positioned in the upper third or middle of the implant reduces the quantity of stress compared to the reference model without a bone graft block. The low bone graft block position is clearly associated with lower stress distribution in compact bone. We registered no significant differences in stress in compact bone with regard to laterotrusion or protrusion. Conclusions: maximum values of von Mises stresses in compact bone can be reduced significantly by using a bone graft block. The reduction of stress is nearly the same for

Angiographic findings of demineralised bone matrix grafts in femoral fracture repair in canines*

International Nuclear Information System (INIS)

Kumar, R.V.S.; Ramakrishna, O.

2000-01-01

Demineralised bone matrix implants and autogenous cancellous bone grafts were evaluated in femoral fracture repair with bone loss in canines, and compared to untreated animals. Angiograms were taken at 3,6,9 and 12 weeks post- operatively using conrary-420 as contrast medium. Early angiograms showed leakage of contrast medium into soft tissue. Grafted groups showed slight hypervascularity and enhanced capillary network. At 12 Weeks the same groups observed nearly normal persistent vascular supply. Early establishment of cortices continuity and draining of contrast medium via extraosseous veins was observed in demineralized bone matrix implanted groups

Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients

Energy Technology Data Exchange (ETDEWEB)

Chan, K.; Pathria, M.; Jacobson, J. [Dept. of Radiology, Univ. of California, San Diego, CA (United States); Resnick, D. [Dept. of Radiology, Veterans Affairs Medical Center, San Diego, CA (United States)

2001-05-01

Objective. To report the imaging findings in nine patients who developed pelvic instability after bone graft harvest from the posterior aspect of the iliac crest.Design and patients. A retrospective study was performed of the imaging studies of nine patients who developed pelvic pain after autologous bone graft was harvested from the posterior aspect of the ilium for spinal arthrodesis. Plain films, bone scans, and CT and MR examinations of the pelvis were reviewed. Pertinent aspects of the clinical history of these patients were noted, including age, gender and clinical symptoms.Results. The age of the patients ranged from 52 to 77 years (average 69 years) and all were women. The bone graft had been derived from the posterior aspect of the iliac crest about the sacroiliac joint. All patients subsequently developed subluxation of the pubic symphysis. Eight patients had additional insufficiency fractures of the iliac crest adjacent to the bone graft donor site, and five patients also revealed subluxation of the sacroiliac joint. Two had insufficiency fractures of the sacrum and one had an additional fracture of the pubic ramus.Conclusions. Pelvic instability is a potential complication of bone graft harvesting from the posterior aspect of the iliac crest. The pelvic instability is manifested by insufficiency fractures of the ilium and subluxation of the sacroiliac joints and pubic symphysis. (orig.)

Pelvic instability after bone graft harvesting from posterior iliac crest: report of nine patients

International Nuclear Information System (INIS)

Chan, K.; Pathria, M.; Jacobson, J.; Resnick, D.

2001-01-01

Objective. To report the imaging findings in nine patients who developed pelvic instability after bone graft harvest from the posterior aspect of the iliac crest.Design and patients. A retrospective study was performed of the imaging studies of nine patients who developed pelvic pain after autologous bone graft was harvested from the posterior aspect of the ilium for spinal arthrodesis. Plain films, bone scans, and CT and MR examinations of the pelvis were reviewed. Pertinent aspects of the clinical history of these patients were noted, including age, gender and clinical symptoms.Results. The age of the patients ranged from 52 to 77 years (average 69 years) and all were women. The bone graft had been derived from the posterior aspect of the iliac crest about the sacroiliac joint. All patients subsequently developed subluxation of the pubic symphysis. Eight patients had additional insufficiency fractures of the iliac crest adjacent to the bone graft donor site, and five patients also revealed subluxation of the sacroiliac joint. Two had insufficiency fractures of the sacrum and one had an additional fracture of the pubic ramus.Conclusions. Pelvic instability is a potential complication of bone graft harvesting from the posterior aspect of the iliac crest. The pelvic instability is manifested by insufficiency fractures of the ilium and subluxation of the sacroiliac joints and pubic symphysis. (orig.)

Effects of Hydroxyapatite on Bone Graft Resorption in an Experimental Model of Maxillary Alveolar Arch Defects

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Ozgur Pilanci

2013-06-01

Full Text Available Most commonly used treatments use autologous bone grafts to address bony defects in patients with cleft palate. Major disadvantages of autogenous bone grafts include donor site morbidity and resorption. Suggestions to overcome such problems include biomaterials that can be used alone or in combination with bone. We examined the effect of hydroxyapatite cement on bone graft resorption in a rabbit maxillary alveolar defect model. We divided 16 young adult albino New Zealand rabbits into two groups. A defect 1 cm wide was created in each rabbit's maxillary arch. In Group 1, the removed bone was disrupted, and the pieces were replaced in the defect. In the other group, the pieces were replaced after mixing (1:1 with hydroxyapatite cement. Quantitative computed tomographic evaluation of these grafts was performed in axial and coronal planes for each rabbit at 2 and 12 weeks. In axial images at 12 weeks, the group without cement showed mean bone resorption of 15%. In the cement group, a mean volumetric increase of 68% was seen. No resorption occurred when bone grafts were mixed with hydroxyapatite cement. [Arch Clin Exp Surg 2013; 2(3.000: 170-175

Reconstruction of the Shallow Acetabulum With a Combination of Autologous Bulk and Impaction Bone Grafting Fixed by Cement.

Science.gov (United States)

Maruyama, Masaaki; Wakabayashi, Shinji; Ota, Hiroshi; Tensho, Keiji

2017-02-01

Acetabular bone deficiency, especially proximal and lateral deficiency, is a difficult technical problem during primary total hip arthroplasty (THA) in developmental dysplasia of the hip (DDH). We report a new reconstruction method using a medial-reduced cemented socket and additional bulk bone in conjunction with impaction morselized bone grafting (additional bulk bone grafting method). In a population of patients with acetabular dysplasia undergoing THA using a medial-reduced cemented socket and additional bulk bone with impacted morselized bone grafting, we evaluated (1) the radiographic appearance of bone graft; (2) the proportion of cups that developed loosening and subsequent revision; and (3) clinical results (outcome scores and complications). Forty percent of 330 THAs for DDH performed at one center between 1999 and 2009 were defined as shallow dysplastic hips. The additional bulk bone grafting method was performed on 102 THAs with shallow acetabulum (31% for DDH) at one center between 1999 and 2009. We used this approach and technique for shallow acetabuli when a cup protruded from the lateral acetabular edge in preoperative templating. The other 132 dysplastic hips without bone grafting had THA performed at the same periods and served as a control. Acetabuli were defined as shallow when the depth was less than or equal to one-fifth of the pelvic height (cranial-caudal length on radiograph). The additional bulk bone grafting technique was as follows: the resected femoral head was sectioned at 1 to 2 cm thickness, and a suitable size of the bulk bone graft was placed on the lateral iliac cortex and fixed by poly-L-lactate absorbable screws. Autologous impaction morselized bone grafting, with or without hydroxyapatite granules, was performed along with the implantation of a medial-reduced cemented socket. We defined an "incorporated" graft as remodeling and trabeculation including rounding off of the protruding edge of a graft beyond the socket

Unicameral bone cysts: a comparison of injection of steroid and grafting with autologous bone marrow.

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Cho, H S; Oh, J H; Kim, H-S; Kang, H G; Lee, S H

2007-02-01

Open surgery is rarely justified for the initial treatment of a unicameral bone cyst, but there is some debate concerning the relative effectiveness of closed methods. This study compared the results of steroid injection with those of autologous bone marrow grafting for the treatment of unicameral bone cysts. Between 1990 and 2001, 30 patients were treated by steroid injection and 28 by grafting with autologous bone marrow. The overall success rates were 86.7% and 92.0%, respectively (p>0.05). The success rate after the initial procedure was 23.3% in the steroid group and 52.0% in those receiving autologous bone marrow (p0.05). The mean number of procedures required was 2.19 (1 to 5) and 1.57 (1 to 3) (p0.05), and the rate of recurrence after the initial procedure was 41.7% and 13.3% in the steroid and in the autologous bone marrow groups, respectively (p<0.05). Although the overall rates of success of both methods were similar, the steroid group had higher recurrence after a single procedure and required more injections to achieve healing.

Vascularized bone grafting in a canine carpal avascular necrosis model

NARCIS (Netherlands)

Willems, Wouter F.; Alberton, Gregory M.; Bishop, Allen T.; Kremer, Thomas

2011-01-01

Limited experimental research has been performed on the treatment of avascular necrosis (AVN) by vascularized bone grafting. A new model simulating carpal AVN was created to investigate surgical revascularization of necrotic bone. In seven mongrel dogs, AVN was induced by removal of the radial

Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

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Sang Yang Lee

2013-01-01

Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion.

Science.gov (United States)

Goyal, Lata

2014-02-01

The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF) and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

Clinical effectiveness of combining platelet rich fibrin with alloplastic bone substitute for the management of combined endodontic periodontal lesion

Directory of Open Access Journals (Sweden)

Lata Goyal

2014-02-01

Full Text Available The term "endo-perio" lesion has been proposed to describe the destructive lesion resulting from inflammatory products found in varying degrees in both the periodontium and the pulpal tissues. In most of the cases, clinical symptoms disappear following successful endodontic therapy. However failure after conventional root canal treatment calls for surgical intervention. A 35 year old male patient with endo-perio lesion in right maxillary lateral incisor was treated with platelet rich fibrin (PRF and alloplastic bone substitute after conventional endodontic therapy. At the end of 6 months there was gain in clinical attachment, increased radiographic bone fill and reduction in probing depth which was maintained till 18 month follow-up. Present case report aims to evaluate the efficacy of PRF and alloplastic bone substitute in the management of intrabony defect associated with endo-perio lesion in maxillary lateral incisor because the healing potential of PRF and bone graft has not been widely studied in endodontics. The use of PRF allows the clinician to optimize tissue remodelling, wound healing and angiogenesis by the local delivery of growth factors and proteins. The novel technique described here enables the clinician to be benefited from the full regenerative capacity of this autologous biologic material.

An alternative method in mandibular fracture treatment: bone graft use instead of a plate.

Science.gov (United States)

Alagöz, Murat Sahin; Uysal, Ahmet Cagri; Sensoz, Omer

2008-03-01

In the treatment of the mandibular fractures, one of the main principles is to use the least amount of foreign material. We present an alternative technique that the bone grafts harvested from the fracture borders or from the iliac crest were used instead of plates and the fixation was done with screws. In the study including 24 mandible fractures, the bone grafts harvested from the fracture borders were used in the 10 favorable fractures and the bone grafts harvested from the iliac crest were used in the 14 unfavorable fractures. In the combined mandible fractures, four fractures were fixated with titanium plates and the other side with the bone graft. The patients, who were followed up for 12 to 20 months, were evaluated with macroscopic occlusion, panoramic graphs, and three-dimensional computerized tomographs. The advantage of this technique of fixation with the autogenous tissue is reduced infection rates and reduced operation costs. In the pediatric patients, the second session operation of plate removal is not necessary.

Accelerated bone ingrowth by local delivery of Zinc from bioactive ...

African Journals Online (AJOL)

Background: Synthetic bone graft substitutes such as bioactive glass (BG) material are developed in order to achieve successful bone regeneration. Zn plays an important role in the proper bone growth, development, and maintenance of healthy bones. Aims: This study aims to evaluate in vivo the performance therapy of ...

Improved Bone Graft Method for Upper Cervical Surgery with Posterior Approach: Technical Description and Report of 52 Cases.

Science.gov (United States)

Wang, Yong-Li; Wang, Xiang-Yang

2018-02-21

We sought to report a minimum 12 months' follow-up results of our improved bone graft method for upper cervical surgery with the posterior approach. Among 52 consecutive cases, odontoid nonunion occurred in 33 patients, atlantoaxial instability in 11 patients, and occipitocervical deformity in 8 patients who underwent posterior C1-C2 transarticular screw/screw-rod internal fixation (41 cases) and occipitocervical fusion (11 cases) with the improved bone graft technique. Each surgical procedure was performed by the same senior spine surgeon. We took lateral cervical standing roentgenograms before surgery and immediately after surgery. Then we conducted craniocerebral computed tomography examination with reconstruction at 3, 6, 12, and 24 months and annually thereafter. The postoperative follow-up times are about 12-38 months. All cases showed satisfactory screw fixation by radiographic examination, and there were no postoperative neurologic complications. One case had postoperative retropharyngeal infection after the transoral release and posterior reduction by pedicle screw instrumentation. All patients got solid fusions, and no pseudarthrosis occurred. All cases had solid fusions at the 3-month follow-up. Good bone graft bed, enough bone graft material, solid local fixation, and effective bone graft method are prerequisites for a successful bone graft. By analyzing postoperative follow-up in the consecutive cases in this study, our bone graft method describing a new bone graft structure is a reliable posterior fusion technique. It is worth considering, and further research is needed. Copyright © 2018. Published by Elsevier Inc.

[Bio-Oss collagen bone grafting in the treatment of endodontic-periodontic lesion].

Science.gov (United States)

Sun, Jiang; Liu, Qiong

2009-09-01

To study the effect of Bio-Oss collagen for bone grafting in the treatment of endodontic-periodontic lesion. Thirty patients (37 teeth) with endodontic-periodontic lesions received root canal therapy and periodontal treatment. Four weeks after the treatment, Bio-Oss collagen was grafted in these teeth. Clinical examinations were performed 1, 3, 6, 9, and 12 months after the surgery. The mobility of these teeth improved 1 month after the surgery. At 3, 6, 9, and 12 months after the surgery, the pocket depth reduced obviously good attachment and further improvement of the tooth mobility. Bio-Oss collagen for bone grafting can achieve good therapeutic effect for endodontic-periodontic lesions.

Volumetric analysis of bone substitute material performance within the human sinus cavity of former head and neck cancer patients: A prospective, randomized clinical trial.

Science.gov (United States)

Lorenz, Jonas; Eichler, Kathrin; Barbeck, Mike; Lerner, Henriette; Stübinger, Stefan; Seipel, Catherine; Vogl, Thomas J; Kovács, Adorján F; Ghanaati, Shahram; Sader, Robert A

2016-01-01

In numerous animal and human studies, it could be detected that in bone augmentation procedures, material's physicochemical characteristics can influence the cellular inflammatory pattern and therefore the integration in the host tissue. Histological, histomorphometrical, and clinical analyses of the integration of the biomaterial in the surrounding tissue are well established methodologies; however, they do not make a statement on volume and density changes of the augmented biomaterial. The aim of the present study was to assess the volume and density of a xenogeneic (Bio-Oss ® , BO) and a synthetic (NanoBone ® , NB) bone substitute material in split-mouth sinus augmentations in former tumor patients to complete histological and histomorphometrical assessment. Immediately and 6 months after sinus augmentation computed tomography scans were recorded, bone grafts were marked, and the volume was calculated with radiologic RIS-PACS software (General Electric Healthcare, Chalfont St. Giles, Great Britain) to determine the integration and degradation behavior of both biomaterials. Radiographic analysis revealed a volume reduction of the initial augmented bone substitute material (i.e. 100%) to 77.36 (±11.68) % in the BO-group, respectively, 75.82 (±22.28) % in the NB-group six months after augmentation. In both materials, the volume reduction was not significant. Bone density significantly increased in both groups. The presented radiological investigation presents a favorable method to obtain clinically relevant information concerning the integration and degradation behavior of bone substitute materials.

Survival of Dental Implants Placed in Grafted and Nongrafted Bone: A Retrospective Study in a University Setting.

Science.gov (United States)

Tran, Duong T; Gay, Isabel C; Diaz-Rodriguez, Janice; Parthasarathy, Kavitha; Weltman, Robin; Friedman, Lawrence

2016-01-01

To compare dental implant survival rates when placed in native bone and grafted sites. Additionally, risk factors associated with dental implant loss were identified. This study was based on the hypothesis that bone grafting has no effect on implant survival rates. A retrospective chart review was conducted for patients receiving dental implants at the University of Texas, School of Dentistry from 1985 to 2012. Exclusion criteria included patients with genetic diseases, radiation and chemotherapy, or an age less than 18 years. To avoid misclassification bias, implants were excluded if bone grafts were only done at the same time of placement. Data on age, sex, tobacco use, diabetes, osteoporosis, anatomical location of the implant, implant length and width, bone graft, and professional maintenance were collected for analysis. A total of 1,222 patients with 2,729 implants were included. The cumulative survival rates at 5 and 10 years were 92% and 87% for implants placed in native bone and 90% and 79% for implants placed in grafted bone, respectively. The results from multivariate analysis (Cox regression) indicated no significant difference in survival between the two groups; having maintenance therapy after implant placement reduced the failure rate by 80% (P dental implant survival rate when implants were placed in native bone or bone-grafted sites. Smoking and lack of professional maintenance were significantly related to increased implant loss.

Development and validation of technique for in-vivo 3D analysis of cranial bone graft survival

Science.gov (United States)

Bernstein, Mark P.; Caldwell, Curtis B.; Antonyshyn, Oleh M.; Ma, Karen; Cooper, Perry W.; Ehrlich, Lisa E.

1997-05-01

Bone autografts are routinely employed in the reconstruction of facial deformities resulting from trauma, tumor ablation or congenital malformations. The combined use of post- operative 3D CT and SPECT imaging provides a means for quantitative in vivo evaluation of bone graft volume and osteoblastic activity. The specific objectives of this study were: (1) Determine the reliability and accuracy of interactive computer-assisted analysis of bone graft volumes based on 3D CT scans; (2) Determine the error in CT/SPECT multimodality image registration; (3) Determine the error in SPECT/SPECT image registration; and (4) Determine the reliability and accuracy of CT-guided SPECT uptake measurements in cranial bone grafts. Five human cadaver heads served as anthropomorphic models for all experiments. Four cranial defects were created in each specimen with inlay and onlay split skull bone grafts and reconstructed to skull and malar recipient sites. To acquire all images, each specimen was CT scanned and coated with Technetium doped paint. For purposes of validation, skulls were landmarked with 1/16-inch ball-bearings and Indium. This study provides a new technique relating anatomy and physiology for the analysis of cranial bone graft survival.

Clinical usefulness of dental X-ray computed tomography for postoperative assessment of secondary alveolar bone grafting

International Nuclear Information System (INIS)

Noguchi, Kazuhide; Hamada, Yoshiki; Kondoh, Toshirou; Ishii, Hiroaki; Sonoyama, Tomoo; Kawarada, Takashi; Seto, Kanichi

2003-01-01

In this study, the clinical usefulness of dental X-ray computed tomography (CT) for postoperative assessment of secondary alveolar bone grafting was investigated. Nineteen bone-grafted alveolar clefts in 15 patients with cleft lip and palate were studied. All bone bridges were examined by dental three-dimensional (3D)-CT (PSR 9000: Asahi Roentgen, Kyoto, Japan). The postoperative 3D morphology of the bone bridges was easily recognized. Dental 3D-CT images were suggested to be useful for assessment before installation of dental implants in bone bridges. In addition, the status of bone surrounding the installed dental implants and the periodontal space of teeth adjacent to the cleft could be clearly evaluated. In conclusion, dental 3D-CT provides clinically valuable information for the postoperative assessment of secondary alveolar bone grafting. (author)

The composite of bone marrow concentrate and PRP as an alternative to autologous bone grafting.

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Mohssen Hakimi

Full Text Available One possible alternative to the application of autologous bone grafts represents the use of autologous bone marrow concentrate (BMC. The purpose of our study was to evaluate the potency of autologous platelet-rich plasma (PRP in combination with BMC. In 32 mini-pigs a metaphyseal critical-size defect was surgically created at the proximal tibia. The animals were allocated to four treatment groups of eight animals each (1. BMC+CPG group, 2. BMC+CPG+PRP group, 3. autograft group, 4. CPG group. In the BMC+CPG group the defect was filled with autologous BMC in combination with calcium phosphate granules (CPG, whereas in the BMC+CPG+PRP group the defect was filled with the composite of autologous BMC, CPG and autologous PRP. In the autograft group the defect was filled with autologous cancellous graft, whereas in the CPG group the defect was filled with CPG solely. After 6 weeks radiological and histomorphometrical analysis showed significantly more new bone formation in the BMC+CPG+PRP group compared to the BMC+CPG group and the CPG group. There were no significant differences between the BMC+CPG+PRP group and the autograft group. In the PRP platelets were enriched significantly about 4.7-fold compared to native blood. In BMC the count of mononuclear cells increased significantly (3.5-fold compared to the bone marrow aspirate. This study demonstrates that the composite of BMC+CPG+PRP leads to a significantly higher bone regeneration of critical-size defects at the proximal tibia in mini-pigs than the use of BMC+CPG without PRP. Furthermore, within the limits of the present study the composite BMC+CPG+PRP represents a comparable alternative to autologous bone grafting.

Biphasic calcium phosphate–casein bone graft fortified with Cassia

Indian Academy of Sciences (India)

Biphasic calcium phosphate; bone graft; Cassia occidentalis; simulated body fluid; SaOS-2 cell line. ... The study investigates the efficacy of CO extract incorporated biphasic calcium phosphate as an osteoinductive material. ... Current Issue

Feasibility of fabricating personalized 3D-printed bone grafts guided by high-resolution imaging

Science.gov (United States)

Hong, Abigail L.; Newman, Benjamin T.; Khalid, Arbab; Teter, Olivia M.; Kobe, Elizabeth A.; Shukurova, Malika; Shinde, Rohit; Sipzner, Daniel; Pignolo, Robert J.; Udupa, Jayaram K.; Rajapakse, Chamith S.

2017-03-01

Current methods of bone graft treatment for critical size bone defects can give way to several clinical complications such as limited available bone for autografts, non-matching bone structure, lack of strength which can compromise a patient's skeletal system, and sterilization processes that can prevent osteogenesis in the case of allografts. We intend to overcome these disadvantages by generating a patient-specific 3D printed bone graft guided by high-resolution medical imaging. Our synthetic model allows us to customize the graft for the patients' macro- and microstructure and correct any structural deficiencies in the re-meshing process. These 3D-printed models can presumptively serve as the scaffolding for human mesenchymal stem cell (hMSC) engraftment in order to facilitate bone growth. We performed highresolution CT imaging of a cadaveric human proximal femur at 0.030-mm isotropic voxels. We used these images to generate a 3D computer model that mimics bone geometry from micro to macro scale represented by STereoLithography (STL) format. These models were then reformatted to a format that can be interpreted by the 3D printer. To assess how much of the microstructure was replicated, 3D-printed models were re-imaged using micro-CT at 0.025-mm isotropic voxels and compared to original high-resolution CT images used to generate the 3D model in 32 sub-regions. We found a strong correlation between 3D-printed bone volume and volume of bone in the original images used for 3D printing (R2 = 0.97). We expect to further refine our approach with additional testing to create a viable synthetic bone graft with clinical functionality.

Mechanical properties of human bone-tendon-bone grafts preserved by different methods and radiation sterilised

International Nuclear Information System (INIS)

Kaminski, A.; Gut, G.

2008-01-01

Full text: Patellar tendon auto and allografts are commonly used in orthopaedic surgery for reconstruction of the anterior crucial ligaments (ACL). Autografts are mainly used for primary reconstruction, while allografts are useful for revision surgery. To avoid the risk of infection diseases transmission allografts should be radiation-sterilised. As radiation-sterilisation is supposed to decrease the mechanical strength of tendon tissue, it is important to establish methods of allografts preservation and sterilisation resulting in their best quality and safety. Therefore, the purpose of the study was to compare the tensile strength of the central one third of human patellar tendon (as used for ACL reconstruction), preserved by different methods (deep fresh freezing, lyophilisation) and subsequently radiation-sterilised with doses of 0 (control), 25, 50 or 100 kGy. Bone-tendon-bone grafts were prepared from cadaveric human patella tendon with both patellar and tibial attachments. BTB grafts were preserved by deep freezing, glicerolisation or lyophilisation and radiation-sterilised with doses of 0 (control), 25, 50 or 100 kGy. To estimate mechanical properties all samples were subjected to tensile tests to failure using Instron system. Before these tests all lyophilised grafts were rehydrated. We found decrease of tensile strength of irradiated grafts compared to non-irradiated controls. Obtained results of the mechanical testing of studied grafts indicate their potential usefulness for clinical applications.(Author)

Evaluation on Bending Properties of Biomaterial GUM Metal Meshed Plates for Bone Graft Applications

Science.gov (United States)

Suzuki, Hiromichi; He, Jianmei

2017-11-01

There are three bone graft methods for bone defects caused by diseases such as cancer and accident injuries: Autogenous bone grafts, Allografts and Artificial bone grafts. In this study, meshed GUM Metal plates with lower elasticity, high strength and high biocompatibility are introduced to solve the over stiffness & weight problems of ready-used metal implants. Basic mesh shapes are designed and applied to GUM Metal plates using 3D CAD modeling tools. Bending properties of prototype meshed GUM Metal plates are evaluated experimentally and analytically. Meshed plate specimens with 180°, 120° and 60° axis-symmetrical types were fabricated for 3-point bending tests. The pseudo bending elastic moduli of meshed plate specimens obtained from 3-point bending test are ranged from 4.22 GPa to 16.07 GPa, within the elasticity range of natural cortical bones from 2.0 GPa to 30.0 GPa. Analytical approach method is validated by comparison with experimental and analytical results for evaluation on bending property of meshed plates.

Evaluation of alveolar bone grafting in unilateral cleft lip and palate patients using a computer-aided diagnosis system

International Nuclear Information System (INIS)

Sutthiprapaporn, Pipop; Kongsomboon, Supaporn; Limmonthol, Saowaluck; Pisek, Poonsak; Keinprasit, Chutimaporn; Tanimoto, Keiji; Nakamoto, Takashi

2012-01-01

This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either 'non-cleft side' or 'cleft side'. The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. The pixel area showed a significant difference between the 'non-cleft side' and 'cleft side' in group 0 (404.27±103.72/117.73±92.25; p=0.00), group 1 (434.29±86.70/388.31±109.51; p=0.01), and group 4 (430.98±98.11/366.71±154.59; p=0.02). No significant differences were found in group 2 (423.57±98.12/383.47±135.88; p=0.06) or group 3 (433.02±116.07/384.16±146.55; p=0.19). Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

Evaluation of alveolar bone grafting in unilateral cleft lip and palate patients using a computer-aided diagnosis system

Energy Technology Data Exchange (ETDEWEB)

Sutthiprapaporn, Pipop; Kongsomboon, Supaporn; Limmonthol, Saowaluck; Pisek, Poonsak; Keinprasit, Chutimaporn [Khon Kaen University, Khon Kaen (Thailand); Tanimoto, Keiji; Nakamoto, Takashi [Dept. of Oral and Maxillofacial Radiology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima (Japan)

2012-09-15

This study aimed to evaluate the trabecular bone changes after alveolar bone grafting in unilateral cleft lip and palate (UCLP) patients using a computer-aided diagnosis (CAD) system. The occlusal radiographs taken from 50 UCLP patients were surveyed retrospectively. The images were categorized as: 50 images in group 0 (before bone grafting), 33 images in group 1 (one month after bone grafting), 24 images in group 2 (2-4 months after bone grafting), 15 images in group 3 (5-7 months after bone grafting), and 21 images in group 4 (8 or more months after bone grafting). Each image was grouped as either 'non-cleft side' or 'cleft side'. The CAD system was used five times for each side to calculate the pixel area based on the mathematical morphology. Significant differences were found using a Wilcoxon signed ranks test or paired samples t test. The pixel area showed a significant difference between the 'non-cleft side' and 'cleft side' in group 0 (404.27{+-}103.72/117.73{+-}92.25; p=0.00), group 1 (434.29{+-}86.70/388.31{+-}109.51; p=0.01), and group 4 (430.98{+-}98.11/366.71{+-}154.59; p=0.02). No significant differences were found in group 2 (423.57{+-}98.12/383.47{+-}135.88; p=0.06) or group 3 (433.02{+-}116.07/384.16{+-}146.55; p=0.19). Based on the design of this study, alveolar bone grafting was similar to normal bone within 2-7 months postoperatively.

Pelvic reconstruction with allogeneic bone graft after tumor resection

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Wang, Wei; Bi, Wen Zhi; Yang, Jing; Han, Gang; Jia, Jin Peng

2013-01-01

OBJECTIVES : Pelvic reconstruction after tumor resection is challenging. METHODS: A retrospective study had been preformed to compare the outcomes among patients who received pelvic reconstructive surgery with allogeneic bone graft after en bloc resection of pelvic tumors and patients who received en bloc resection only. RESULTS: Patients without reconstruction had significantly lower functional scores at 3 months (10 vs. 15, P = 0.001) and 6 months after surgery (18.5 vs. 22, P = 0.0024), a shorter duration of hospitalization (16 day vs. 40 days, P 0.05). CONCLUSIONS : Pelvic reconstruction with allogeneic bone graft after surgical management of pelvic tumors is associated with satisfactory surgical and functional outcomes. Further clinical studies are required to explore how to select the best reconstruction method. Level of Evidence IV, Case Series. PMID:24453659

Clinical evaluation of sinus bone graft in patients with mucous retention cyst.

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Kim, Seong-Beom; Yun, Pil-Young; Kim, Young-Kyun

2016-12-01

Mucous retention cyst refers to a cyst made by expansion due to the blockage of the salivary gland near the maxillary sinus, and it is surrounded by epithelial cells. Most of them are small; therefore, they cannot be found well and are frequently with antral polyp. The aim of this study was to evaluate the clinical prognosis of sinus bone graft in patients with mucous retention cyst. This study was performed retrospectively on 23 patients who had sinus bone graft. Group 1 was 8 patients (10 sinuses) who had a mucous retention cyst, and group 2 was 15 patients (17 sinuses) who had no pathologic history about the maxillary sinus. For these patients, sinus bone graft was performed using the lateral approach technique. The total 51 implants were placed 6.22 weeks on the average after sinus bone graft. Sinus membrane perforation during operation, postoperative complications, marginal bone loss after restorative function, implant success rate, and survival rate were analyzed. There was no complication in group 1, and there were three complications in group 2. In group 2, two cases of implants failed. The types of postoperative complications consisted of two minor infections and one wound dehiscence. Two implants of total 51 implants were removed, and the survival rate of implants was 96.08 % (group 1 100 %, group 2 93.5 %). The total success rate of implants was 92.2 % (group 1 95 %, group 2 90.3 %). The clinical prognosis was not affected by the presence of mucous retention cyst.

BoneCeramic graft regenerates alveolar defects but slows orthodontic tooth movement with less root resorption.

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Ru, Nan; Liu, Sean Shih-Yao; Bai, Yuxing; Li, Song; Liu, Yunfeng; Wei, Xiaoxia

2016-04-01

BoneCeramic (Straumann, Basel, Switzerland) can regenerate bone in alveolar defects after tooth extraction, but it is unknown whether it is feasible to move a tooth through BoneCeramic grafting sites. The objective of this study was to investigate 3-dimensional real-time root resorption and bone responses in grafted sites during orthodontic tooth movement. Sixty 5-week-old rats were randomly assigned to 3 groups to receive BoneCeramic, natural bovine cancellous bone particles (Bio-Oss; Geistlich Pharma, Wolhusen, Switzerland), or no graft, after the extraction of the maxillary left first molar. After 4 weeks, the maxillary left second molar was moved into the extraction site for 28 days. Dynamic bone microstructures and root resorption were evaluated using in-vivo microcomputed tomography. Stress distribution and corresponding tissue responses were examined by the finite element method and histology. Mixed model analysis of variance was performed to compare the differences among time points with Bonferroni post-hoc tests at the significance level of P root resorption volumes and craters, and the highest bone volume fraction, trabecular number, and mean trabecular thickness, followed by the Bio-Oss and the control groups. The highest stress accumulated in the cervical region of the mesial roots. BoneCeramic has better osteoconductive potential and induces less root resorption compared with Bio-Oss grafting and naturally recovered extraction sites. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Radial bone graft usage for nasal septal reconstruction

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Yakup Cil

2011-01-01

Full Text Available Background: Although various techniques have been described for correction of crooked and saddle nose deformities, these problems are challenging with high recurrence and revision rates. Conventional septal surgery may not be adequate for nose reconstruction in crooked and saddle nose deformities. Materials and Methods: Between December 2005 and October 2009, six patients with crooked nose and five patients with saddle nose deformities underwent corrective surgery in our clinic. All patients were male, and the mean age was 21 years (range, 19-23 years. We used rigid radial bone graft to prevent redeviation and recurrence following corrective nasal septal surgery. Results: The mean follow-up period was 28 months, ranging from 18 to 46 months. Mean operation time was 4 hours (3-4.5. All patients healed uneventfully. None of the patients required secondary surgery. Conclusions: We believe that radial bone grafts offer a long lasting support in treatment of challenging cases with crooked and saddle nose deformities.

Evaluation of injectable silica-embedded nanohydroxyapatite bone substitute in a rat tibia defect model

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Xu W

2011-08-01

Full Text Available Weiguo Xu1, Cornelia Ganz2, Ulf Weber2, Martin Adam2, Gerd Holzhüter2, Daniel Wolter3, Bernhard Frerich3, Brigitte Vollmar1, Thomas Gerber21Institute for Experimental Surgery, 2Institute of Physics, 3Department of Oral, Maxillofacial and Plastic Surgery, University of Rostock, Rostock, GermanyAbstract: In clinical practice, vertebral compression fractures occur after trauma and osteoporosis. Kyphoplasty is a minimally invasive procedure using bone filler material for the treatment of such fractures. A full synthetic injectable bone substitute (SIBS was manufactured by means of spray drying. The aim of this study was to characterize the SIBS and to analyze the remodelling process during degradation of the biomaterial and new bone formation after implantation. SIBS is an aqueous suspension of donut-like microparticles. These microparticles consist of nanocrystallites of synthetic hydroxyapatite embedded in amorphous silica gel. After implantation of SIBS in a proximal tibial diaphyseal defect in 52 rats, grafts were harvested for subsequent analysis on different days. Newly formed bone originating from endosteum was observed on day 6. Hematomas in the medullary space and cortical wounds disappeared on day 12. The wound region was completely replaced by a composite of newly formed cancellous bone, extracellular matrix, and SIBS. At day 63 the cortical defect was fully healed by bone, while newly formed bone in the medullary space almost disappeared and was replaced with bone marrow. In conclusion, SIBS demonstrated a unique structure with osteoinductive and bioresorbable properties, which induced fast bone regeneration. Therefore, a clinical application of SIBS for kyphoplasty is promising.Keywords: bone remodelling, electron microscopy, histomorphometry, nanotechnology, tissue engineering

A study of 23 unicameral bone cysts of the calcaneus: open chip allogeneic bone graft versus percutaneous injection of bone powder with autogenous bone marrow.

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Park, Il-Hyung; Micic, Ivan Dragoljub; Jeon, In-Ho

2008-02-01

The treatment of unicameral bone cyst varies from percutaneous needle biopsy, aspiration and local injection of steroid, autologous bone marrow, or demineralized bone matrix to curettage and open bone-grafting. The purpose of this study was to compare the results of open chip allogeneic bone graft versus percutaneous injection of demineralized bone powder with autogenous bone marrow in management of calcaneal cysts. Twenty-three calcaneal unicameral cysts in 20 patients were treated. Lyophilized irradiated chip allogeneic bone (CAB) and autogenous bone marrow were used for treatment of 13 cysts in 11 patients, and 10 cysts in 9 patients were treated with percutaneous injection of irradiated allogeneic demineralized bone powder (DBP) and autogenous bone marrow. There were 11 males and 9 female patients with mean age of 17 years. The patients were followed for an average of 49.4 months. Complete healing was achieved in 9 cysts treated with chip allogeneic bone and in 5 cysts treated with powdered bone. Four cysts treated with CAB and 3 cysts treated with DBP healed with a defect. Two cysts treated with powdered bone and autogenous bone marrow were classified as persistent. No infections or pathological fractures were observed during the followup period. Percutaneous injection of a mixture of allogeneic bone powder with autogenous bone marrow is a minimal invasive method and could be an effective alternative in the treatment of unicameral calcaneal bone cysts. The postoperative morbidity was low, the hospital stay was brief, and patient's comfort for unrestricted activity was enhanced.

Comparing membranes and bone substitutes in a one-stage procedure for horizontal bone augmentation. A double-blind randomised controlled trial.

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Merli, Mauro; Moscatelli, Marco; Mariotti, Giorgia; Pagliaro, Umberto; Raffaelli, Eugenia; Nieri, Michele

2015-01-01

The objective of this parallel randomised controlled trial is to compare two bone substitutes and collagen membranes in a one-stage procedure for horizontal bone augmentation: anorganic bovine bone (Bio-Oss) and collagen porcine membranes (Bio-Gide) (BB group) versus a synthetic resorbable bone graft substitute made of pure β-tricalcium phosphate (Ceros TCP) and porcine pericardium collagen membranes (Jason) (CJ group). Patients in need of implant treatment having at least one site with horizontal osseous defects at a private clinic in Rimini (Italy) were included in this study. Patients were randomised to receive either the BB or CJ treatment. Randomisation was computer-generated with allocation concealment by opaque sequentially numbered sealed envelopes. Patients and the outcome assessor were blinded to group assignment. The main outcome measures were implant failure, complications, clinical bone gain at augmented sites, and complete filling of the bone defect. Secondary outcome measures were chair-time, postoperative pain and peri-implant marginal bone level changes. Twenty-five patients with 32 implants were allocated to the BB group and 25 patients with 29 implants to the CJ group. All 50 randomised patients received the treatment as allocated and there were no dropouts up to 6-months post-loading (12 months post-surgery). There were no failures and there were three complications in the BB group and three complications in the CJ group (relative risk: 1.00, 95% CI from 0.22 to 4.49, P = 1.00). The estimated difference between treatments in the vertical defect bone gain was -0.15 mm (95% CI from -0.65 to 0.35, P = 0.5504) favouring the BB group, and the estimated difference between treatments in the horizontal defect bone gain was -0.27 mm (95%CI from -0.73 to 0.19, P = 0.3851) favouring the BB group. There was no difference in the complete filling of the defect (relative risk: 0.88, 95%CI from 0.58 to 1.34, P = 0.7688). No significant differences were

Piezosurgical osteotomy for harvesting intraoral block bone graft

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Lakshmiganthan, Mahalingam; Gokulanathan, Subramanium; Shanmugasundaram, Natarajan; Daniel, Rajkumar; Ramesh, Sadashiva B.

2012-01-01

The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient's psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device. PMID:23066242

Piezosurgical osteotomy for harvesting intraoral block bone graft

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Mahalingam Lakshmiganthan

2012-01-01

Full Text Available The use of ultrasonic vibrations for the cutting of bone was first introduced two decades ago. Piezoelectric surgery is a minimally invasive technique that lessens the risk of damage to surrounding soft tissues and important structures such as nerves, vessels, and mucosa. It also reduces damage to osteocytes and permits good survival of bony cells during harvesting of bone. Grafting with intraoral bone blocks is a good way to reconstruct severe horizontal and vertical bone resorption in future implants sites. The piezosurgery system creates an effective osteotomy with minimal or no trauma to soft tissue in contrast to conventional surgical burs or saws and minimizes a patient′s psychological stress and fear during osteotomy under local anesthesia. The purpose of this article is to describe the harvesting of intraoral bone blocks using the piezoelectric surgery device.

Clinical evaluation of sinus bone graft in patients with mucous retention cyst

OpenAIRE

Kim, Seong-Beom; Yun, Pil-Young; Kim, Young-Kyun

2016-01-01

Background Mucous retention cyst refers to a cyst made by expansion due to the blockage of the salivary gland near the maxillary sinus, and it is surrounded by epithelial cells. Most of them are small; therefore, they cannot be found well and are frequently with antral polyp. The aim of this study was to evaluate the clinical prognosis of sinus bone graft in patients with mucous retention cyst. Methods This study was performed retrospectively on 23 patients who had sinus bone graft. Group 1 w...

Revascularization of femoral head ischemic necrosis with vascularized bone graft: A CT scan experimental study

International Nuclear Information System (INIS)

Gonzalez del Pino, J.; Knapp, K.; Gomez Castresana, F.; Benito, M.

1990-01-01

An ischemic necrosis of the femoral head was induced in 15 mongrel adult dogs using the technique described by Gartsman et al. Five weeks later, a free vascularized rib graft was transferred into the previously induced ischemic femoral head. High resolution computed tomographic scanning was used to evaluate revascularization 4, 8 and 12 weeks after grafting. The femoral head exhibited new vessel formation throughout the study. Arterial terminal branches arising from the rib graft medullary and periosteal circulations extended beyond the rib graft, entered the head, and reached the subchondral plate. Even where the rib graft did not replenish the central core of the head, there was vascular supply from the grafted bone's vascular tree. These results suggest that a free vascularized bone graft is able to revascularize an experimentally induced ischemic femoral head necrosis. (orig.)

Secondary bone grafting for alveolar cleft in children with cleft lip or cleft lip and palate

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Guo, J.; Li, C.; Zhang, Q.; Wu, G.; Deacon, S.A.; Chen, J.; Hu, H.; Zou, S.; Ye, Q.

2011-01-01

BACKGROUND: Secondary alveolar bone grafting has been widely used to reconstruct alveolar cleft. However, there is still some controversy. OBJECTIVES: To compare the effectiveness and safety of different secondary bone grafting methods. SEARCH STRATEGY: The final electronic and handsearches were

Engineering bone grafts with enhanced bone marrow and native scaffolds.

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Hung, Ben P; Salter, Erin K; Temple, Josh; Mundinger, Gerhard S; Brown, Emile N; Brazio, Philip; Rodriguez, Eduardo D; Grayson, Warren L

2013-01-01

The translation of tissue engineering approaches to the clinic has been hampered by the inability to find suitable multipotent cell sources requiring minimal in vitro expansion. Enhanced bone marrow (eBM), which is obtained by reaming long bone medullary canals and isolating the solid marrow putty, has large quantities of stem cells and demonstrates significant potential to regenerate bone tissues. eBM, however, cannot impart immediate load-bearing mechanical integrity or maintain the gross anatomical structure to guide bone healing. Yet, its putty-like consistency creates a challenge for obtaining the uniform seeding necessary to effectively combine it with porous scaffolds. In this study, we examined the potential for combining eBM with mechanically strong, osteoinductive trabecular bone scaffolds for bone regeneration by creating channels into scaffolds for seeding the eBM. eBM was extracted from the femurs of adult Yorkshire pigs using a Synthes reamer-irrigator-aspirator device, analyzed histologically, and digested to extract cells and characterize their differentiation potential. To evaluate bone tissue formation, eBM was seeded into the channels in collagen-coated or noncoated scaffolds, cultured in osteogenic conditions for 4 weeks, harvested and assessed for tissue distribution and bone formation. Our data demonstrates that eBM is a heterogenous tissue containing multipotent cell populations. Furthermore, coating scaffolds with a collagen hydrogel significantly enhanced cellular migration, promoted uniform tissue development and increased bone mineral deposition. These findings suggest the potential for generating customized autologous bone grafts for treating critical-sized bone defects by combining a readily available eBM cell source with decellularized trabecular bone scaffolds. © 2013 S. Karger AG, Basel

Reconstruction of mandibular defects using nonvascularized autogenous bone graft in Nigerians

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Kizito Chioma Ndukwe

2014-01-01

Full Text Available Objectives: The aim of this study is to evaluate the success rate and complications of mandibular reconstruction with nonvascularized bone graft in Ile-Ife, Nigeria. Patients and Methods: A total of 25 patients who underwent reconstruction of mandibular discontinuity defects between January 2003 and February 2012, at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife constituted the study sample. Relevant information was retrieved from the patients′ records. This information include patients′ demographics (age and sex as well as the type of mandibular defect, cause of the defect, type of mandibular resection done, source of the bone graft used, and the method of graft immobilization. Morbidity associated with the graft procedures were assessed by retrieving information on graft failures, length of hospital stay following surgery, rehabilitation device used and associated graft donor and recipient site complications. Result: There were 12 males and 13 females with a male:female ratio was 1:1.1. The age of the patients ranged from 13 to 73 years with a mean age for males 32.7 ± standard deviation (SD 12.9 and for females 35.0 ± SD 17.1. Jaw defect was caused by resection for tumours and other jaw pathologies in 92% of cases. Complete symphyseal involvement defect was the most common defect recorded 11 (44%. Reconstruction with nonvascularized rib graft accounted for 68% of cases while iliac crest graft was used in 32% of the patients. Successful take of the grafts was recorded in 22 patients while three cases failed. Wound dehiscence (two patients and postoperative wound infection (eight patients were the most common complications recorded. Conclusion: The use of nonvascularized graft is still relevant in the reconstruction of large mandibular defects caused by surgical ablation of benign conditions in Nigerians. Precise surgical planning and execution, extended antibiotic therapy, and meticulous postoperative care

Variation of the bone forming ability with the physicochemical properties of calcium phosphate bone substitutes

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Duan, Rongquan; Barbieri, Davide; Luo, Xiaoman; Weng, Jie; Bao, Chongyun; De Bruijn, Joost D.; Yuan, Huipin

2018-01-01

Because of their bioactive properties and chemical similarity to the inorganic component of bone, calcium phosphate (CaP) materials are widely used for bone regeneration. Six commercially available CaP bone substitutes (Bio-Oss, Actifuse, Bi-Ostetic, MBCP, Vitoss and chronOs) as well as two

* Hypoxia Biomimicry to Enhance Monetite Bone Defect Repair.

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Drager, Justin; Ramirez-GarciaLuna, Jose Luis; Kumar, Abhishek; Gbureck, Uwe; Harvey, Edward J; Barralet, Jake E

2017-12-01

Tissue hypoxia is a critical driving force for angiogenic and osteogenic responses in bone regeneration and is, at least partly, under the control of the Hypoxia Inducible Factor-1α (HIF-1α) pathway. Recently, the widely used iron chelator deferoxamine (DFO) has been found to elevate HIF-1α levels independent of oxygen concentrations, thereby, creating an otherwise normal environment that mimics the hypoxic state. This has the potential to augment the biological properties of inorganic scaffolds without the need of recombinant growth factors. This pilot study investigates the effect of local delivery of DFO on bone formation and osseointegration of an anatomically matched bone graft substitute, in the treatment of segmental bone defects. Three-dimensional printing was used to create monetite grafts, which were implanted into 10 mm midshaft ulnar defects in eight rabbits. Starting postoperative day 4, one graft site in each animal was injected with 600 μL (200 μM) of DFO every 48 h for six doses. Saline was injected in the contralateral limb as a control. At 8 weeks, micro-CT and histology were used to determine new bone growth, vascularity, and assess osseointegration. Six animals completed the protocol. Bone metric analysis using micro-CT showed a significantly greater amount of new bone formed (19.5% vs. 13.65% p = 0.042) and an increase in bone-implant contact area (63.1 mm 2 vs. 33.2 mm 2 p = 0.03) in the DFO group compared with control. Vascular channel volume was significantly greater in the DFO group (20.9% vs. 16.2% p = 0.004). Histology showed increased bone formation within the osteotomy gap, more bone integrated with the graft surface as well as more matured soft tissue callus in the DFO group. This study demonstrates a significant increase in new bone formation after delivery of DFO in a rabbit long bone defect bridged by a 3D-printed bioresorbable bone graft substitute. Given the safety, ease of handling, and low expense of

RECONSTRUCTION OF ATROPHIC MAXILLA BY ANTERIOR ILIAC CREST BONE GRAFTING VIA NEUROAXIAL BLOCKADE TECHNIQUE: A CASE REPORT

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Erol CANSIZ

2017-01-01

Full Text Available Anterior iliac crest bone grafting is a well-established modality in the treatment of alveolar bone deficiencies. However, this procedure may also have considerable postoperative morbidity which is mostly related to general anesthesia. Postoperative pain-related complications can be managed by neuroaxial blockade techniques which provide adequate surgical analgesia and reduce postoperative pain. This clinical report describes the reconstruction of a severely atrophic maxilla with anterior iliac crest bone grafting using combined spinal epidural anesthesia. Neuroaxial blockade techniques may be a useful alternative to eliminate general anesthesia related challenges of anterior iliac crest bone grafting procedures.

Marker for the pre-clinical development of bone substitute materials

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de Wild Michael

2017-09-01

Full Text Available Thin mechanically stable Ti-cages have been developed for the in-vivo application as X-ray and histology markers for the optimized evaluation of pre-clinical performance of bone graft materials. A metallic frame defines the region of interest during histological investigations and supports the identification of the defect site. This standardization of the procedure enhances the quality of pre-clinical experiments. Different models of thin metallic frameworks were designed and produced out of titanium by additive manufacturing (Selective Laser Melting. The productibility, the mechanical stability, the handling and suitability of several frame geometries were tested during surgery in artificial and in ex-vivo bone before a series of cages was preclinically investigated in the female Göttingen minipigs model. With our novel approach, a flexible process was established that can be adapted to the requirements of any specific animal model and bone graft testing.

Knowledge on Bone Banking among Participants in an Orthopaedic Conference: A Preliminary Survey

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Mohd S

2017-07-01

Full Text Available Despite increasing use of bone graft in Malaysia, there was still lack of data to quantify knowledge level on bone banking among orthopaedic community who are involved in transplantation related work. Therefore, a survey on awareness in tissue banking specifically bone banking, usage and choice of bone grafts was conducted. From 80 respondents, 82.5% were aware about tissue banking however only 12.5% knew of the existence of tissue banks in Malaysia. Femoral head was the bone allograft most often used as a substitute to autograft. Only 34.8% respondents preferred irradiated bone grafts whilst 46.9% preferred nonirradiated, indicating the need to educate the importance of radiation for sterilising tissues. Exhibition was the most preferred medium for awareness programme to disseminate information about bone banking in the orthopaedic community. The professional awareness is necessary to increase the knowledge on the use of bone graft, hence to increase bone transplantation for musculoskeletal surgeries in the country.

Knowledge on Bone Banking among Participants in an Orthopaedic Conference: A Preliminary Survey.

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Mohd, S; Yusof, N; Ramalingam, S; Ng, W M; Mansor, A

2017-07-01

Despite increasing use of bone graft in Malaysia, there was still lack of data to quantify knowledge level on bone banking among orthopaedic community who are involved in transplantation related work. Therefore, a survey on awareness in tissue banking specifically bone banking, usage and choice of bone grafts was conducted. From 80 respondents, 82.5% were aware about tissue banking however only 12.5% knew of the existence of tissue banks in Malaysia. Femoral head was the bone allograft most often used as a substitute to autograft. Only 34.8% respondents preferred irradiated bone grafts whilst 46.9% preferred nonirradiated, indicating the need to educate the importance of radiation for sterilising tissues. Exhibition was the most preferred medium for awareness programme to disseminate information about bone banking in the orthopaedic community. The professional awareness is necessary to increase the knowledge on the use of bone graft, hence to increase bone transplantation for musculoskeletal surgeries in the country.

Resorption behavior of a nanostructured bone substitute: in vitro investigation and clinical application.

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Reichert, Christoph; Götz, Werner; Reimann, Susanne; Keilig, Ludger; Hagner, Martin; Bourauel, Christoph; Jäger, Andreas

2013-03-01

To develop an in vitro assay for quantitative analysis of the degradation to which a bone substitute is exposed by osteoclasts. The aim of establishing this method was to improve the predictability of carrying out tooth movements via bone substitutes and to provide a basis for verification in exemplary clinical cases. After populating a bone substitute (NanoBone®; ArtOss, Germany) with osteoclastic cells, inductively-coupled mass spectrometry was used to evaluate changing calcium levels in the culture medium as a marker of resorption activity. It was observed that calcium levels increased substantially in the culture medium with the cells populating the bone substitute. This in vitro assay is a valid method that can assist clinicians in selecting the appropriate materials for certain patients. While tooth movements occurring through this material were successful, uncertainty about the approach will remain as long-term results are not available.

Bone grafting with granular biomaterial in segmental maxillary osteotomy: A case report

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Orion Luiz Haas Junior

2016-01-01

Conclusion: This is the first report of bone grafting with a granular biomaterial in segmental maxillary osteotomy. Successful formation of new bone with density greater than that of the surrounding tissue was achieved, preventing pseudarthrosis and postoperative instability.

Engineering anatomically shaped vascularized bone grafts with hASCs and 3D-printed PCL scaffolds.

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Temple, Joshua P; Hutton, Daphne L; Hung, Ben P; Huri, Pinar Yilgor; Cook, Colin A; Kondragunta, Renu; Jia, Xiaofeng; Grayson, Warren L

2014-12-01

The treatment of large craniomaxillofacial bone defects is clinically challenging due to the limited availability of transplantable autologous bone grafts and the complex geometry of the bones. The ability to regenerate new bone tissues that faithfully replicate the anatomy would revolutionize treatment options. Advances in the field of bone tissue engineering over the past few decades offer promising new treatment alternatives using biocompatible scaffold materials and autologous cells. This approach combined with recent advances in three-dimensional (3D) printing technologies may soon allow the generation of large, bioartificial bone grafts with custom, patient-specific architecture. In this study, we use a custom-built 3D printer to develop anatomically shaped polycaprolactone (PCL) scaffolds with varying internal porosities. These scaffolds are assessed for their ability to support induction of human adipose-derived stem cells (hASCs) to form vasculature and bone, two essential components of functional bone tissue. The development of functional tissues is assessed in vitro and in vivo. Finally, we demonstrate the ability to print large mandibular and maxillary bone scaffolds that replicate fine details extracted from patient's computed tomography scans. The findings of this study illustrate the capabilities and potential of 3D printed scaffolds to be used for engineering autologous, anatomically shaped, vascularized bone grafts. © 2014 Wiley Periodicals, Inc.

Anterior Cranial Base Reconstruction with a Reverse Temporalis Muscle Flap and Calvarial Bone Graft

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Seung Gee Kwon

2012-07-01

Full Text Available BackgroundCranial base defects are challenging to reconstruct without serious complications. Although free tissue transfer has been used widely and efficiently, it still has the limitation of requiring a long operation time along with the burden of microanastomosis and donor site morbidity. We propose using a reverse temporalis muscle flap and calvarial bone graft as an alternative option to a free flap for anterior cranial base reconstruction.MethodsBetween April 2009 and February 2012, cranial base reconstructions using an autologous calvarial split bone graft combined with a reverse temporalis muscle flap were performed in five patients. Medical records were retrospectively analyzed and postoperative computed tomography scans, magnetic resonance imaging, and angiography findings were examined to evaluate graft survival and flap viability.ResultsThe mean follow-up period was 11.8 months and the mean operation time for reconstruction was 8.4±3.36 hours. The defects involved the anterior cranial base, including the orbital roof and the frontal and ethmoidal sinus. All reconstructions were successful. Viable flap vascularity and bone survival were observed. There were no serious complications except for acceptable donor site depressions, which were easily corrected with minor procedures.ConclusionsThe reverse temporalis muscle flap could provide sufficient bulkiness to fill dead space and sufficient vascularity to endure infection. The calvarial bone graft provides a rigid framework, which is critical for maintaining the cranial base structure. Combined anterior cranial base reconstruction with a reverse temporalis muscle flap and calvarial bone graft could be a viable alternative to free tissue transfer.

Iatrogenic giant cell tumor at bone graft harvesting site

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Zile S Kundu

2013-01-01

Full Text Available 30 year old female patient with giant cell tumor of the distal tibia initially treated at a peripheral nononcological center by curettage and autologous bone grafting from the ipsilateral iliac crest reported to us with local recurrence and an implantation giant cell tumor at the graft harvesting site which required extensive surgeries at both sites. The risk of iatrogenic direct implantation of tumor, often attributable to inadequate surgical planning or poor surgical techniques, and the steps to prevent such complication is reported here.

Influence of Healing Period Upon Bone Turn Over on Maxillary Sinus Floor Augmentation Grafted Solely with Deproteinized Bovine Bone Mineral: A Prospective Human Histological and Clinical Trial.

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Wang, Feng; Zhou, Wenjie; Monje, Alberto; Huang, Wei; Wang, Yueping; Wu, Yiqun

2017-04-01

To investigate the influence of maturation timing upon histological, histomorphometric and clinical outcomes when deproteinized bovine bone mineral (DBBM) was used as a sole biomaterial for staged maxillary sinus floor augmentation (MSFA). Patients with a posterior edentulous maxillary situation and a vertical bone height ≤ 4 mm were included in this study. A staged MSFA was carried out. After MSFA with DBBM as a sole grafting material, biopsy cores were harvested with simultaneous implant placement followed by a healing period of 5, 8, and 11 months, respectively. Micro-CT, histologic and histomorphometric analyses were performed. Forty-one patients were enrolled and 38 bone core biopsies were harvested. Significantly greater BV/TV was observed between 5- and 8-month healing from micro-CT analysis. Histomorphometric analyses showed the ratio of mineralized newly formed bone increased slightly from 5 to 11 months; however, no statistically significant difference was reached (p = .409). Residual bone substitute decreased from 37.3 ± 5.04% to 20.6 ± 7.45%, achieving a statistical significant difference from of 5 up to 11 months (p < .01). Moreover, no implant failure, biological or technical complication occurred after 12-month follow-up of functional loading. DBBM utilized as sole grafting material in staged MSFA demonstrated to be clinically effective regardless of the healing period. Histomorphometrical and micro-CT assessments revealed that at later stages of healing (8 and 11 months) there is a higher proportion of newly-bone formation compared to earlier stages (5 months). Moreover, the longer the maturation period, the substantially lesser remaining biomaterial could be expected. Even though, these facts did not seem to negatively impact on the implant prognosis 1-year after loading. © 2016 Wiley Periodicals, Inc.

Autologous fat graft and bone marrow-derived mesenchymal stem cells assisted fat graft for treatment of Parry-Romberg syndrome.

Science.gov (United States)

Jianhui, Zhao; Chenggang, Yi; Binglun, Lu; Yan, Han; Li, Yang; Xianjie, Ma; Yingjun, Su; Shuzhong, Guo

2014-09-01

Progressive facial hemiatrophy, also called Parry-Romberg syndrome (PRS), is characterized by slowly progressive atrophy of one side of the face and primarily involves the subcutaneous tissue and fat. The restoration of facial contour and symmetry in patients affected by PRS still remains a challenge clinically. Fat graft is a promising treatment but has some shortcomings, such as unpredictability and low rate of graft survival due to partial necrosis. To obviate these disadvantages, fat graft assisted by bone marrow-derived mesenchymal stem cells (BMSCs) was used to treat PRS patients and the outcome was evaluated in comparison with the conventional treatment by autologous fat graft. Autologous fat graft was harvested by tumescent liposuction. Bone marrow-derived mesenchymal stem cells were then isolated by human Lymphocytes Separation Medium through density gradient centrifugation. Twenty-six patients were treated with autologous fat graft only (group A), whereas 10 other patients were treated with BMSC-assisted fat graft (group B). The Coleman technique was applied in all fat graft injections. The follow-up period was 6 to 12 months in this study, In group A, satisfactory outcome judged by symmetrical appearances was obtained with 1 injection in 12 patients, 2 injections in 8 patients, and 3 injections in 4 patients. However, the result of 1 patient was not satisfactory and 1 patient was overcorrected. In group B, 10 patients obtained satisfactory outcomes and almost reached symmetry by 1 injection. No complications (infection, hematoma, or subcutaneous mass) were observed. The results suggest that BMSC-assisted fat graft is effective and safe for soft tissue augmentation and may be superior to conventional lipoinjection. Additional study is necessary to further evaluate the efficacy of this technique.

Unprotected autogenous bone block grafts in anterior maxilla: Resorption rates and clinical outcomes

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Kosanić Ivan

2017-01-01

Full Text Available Background/Aim. The use of autogenous bone grafts for augmentation of the resorbed alveolar ridge is still considered the gold standard in implant dentistry. The aim of this study was to analyze the resorption rate of autogenous bone block grafts from the retromolar region placed in the frontal segment of the upper jaw unprotected by barrier membranes, to assess the stability of implants placed into the grafted bone, as well as to monitor its changes during the healing period. Methods. The study included 18 patients with a total of 20 grafted sites. The residual alveolar ridge was measured before and after the augmentation and prior to implant placement. All implants were restored with provisional crowns within 48 hours after the placement. Implant stability was assessed using resonance frequency analysis. Results. The average period from ridge augmentation to reentry was 5.4 months (range 4–6 months. At reentry the healed alveolar ridge had a mean width of 6.1 ± 1.27 mm. The mean calculated width gain was 3.04 ± 1.22 mm. The overall surface resorption of block grafts was 0.68 ± 0.69 mm (18.85%. At the time of implant placement the mean value of implant stability quotient (ISQ was 71.25 ± 5.77. The lowest ISQ values were noted after three weeks of healing, followed by a gradual increase until week 12. After 12 weeks implants showed significantly higher ISQ values compared to primary stability (p < 0.05 Wilcoxon signed ranks test. During the 3-years followup period no cases of implant loss were recorded. Conclusion. Despite a significant resorption of bone grafts, it was possible to place implants in all the cases and to use the immediate loading protocol without affecting implant survival rate. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no.175021

Alveolar cleft closure with iliac bone graft: A case report.

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Tichvy Tammama

2017-04-01

Conclusion: The timing of alveolar bone grafting usually associated with the state of the developing of dentition. Post operative management is important to get a good result, and to prevent any complications.

Do Bone Graft and Cracking of the Sclerotic Cavity Improve Fixation of Titanium and Hydroxyapatite-coated Revision Implants in an Animal Model?

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Elmengaard, Brian; Baas, Joergen; Jakobsen, Thomas; Kold, Soren; Jensen, Thomas B; Bechtold, Joan E; Soballe, Kjeld

2017-02-01

mechanical shear strength, stiffness, and energy to failure (for Ti6Al4V 27- to 69-fold increase and HA twofold increases). The histomorphometric analysis demonstrated primarily fibrous membrane ongrowth and in the gap for the allografted Ti6Al4V noncrack revisions. For allografted HA noncrack revisions, bone ongrowth at the implant surface was observed, but fibrous tissue also was present in the inner gap. Although both Ti6Al4V and HA surfaces showed improved fixation with grafted crack revision, and Ti6Al4V achieved the highest percent gain, HA demonstrated the strongest overall fixation. The results of this study suggest that novel osteoconductive or osteoinductive coatings and bone graft substitutes or tissue-engineered constructs may further improve bone-implant fixation with the crack revision technique but require evaluation in a rigorous model such as presented here. This experimental study provides data on which to base clinical trials aimed to improve fixation of revision implants. Given the multifactorial nature of complex human revisions, such a protocoled clinical study is required to determine the clinical applicability of this approach.

Comparison of Puddu osteotomy with or without autologous bone grafting: a prospective clinical trial

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Marcus Ceregatti Passarelli

Full Text Available ABSTRACT Objectives: To test the hypothesis that autologous iliac bone grafts do not enhance clinical results and do not decrease complication rates in patients undergoing medial opening-wedge high tibial , osteotomy. Methods: Forty patients allocated in a randomized, two-armed, double-blinded clinical trial were evaluated between 2007 and 2010. One group received bone graft, and the other group was left without filling the osteotomy defect. The primary outcome was the Knee Society Score. , Radiographic measurement of the frontal anatomical femoral-tibial angle and the progression of osteoarthritis according to the modified Ahlback classification were used as secondary outcomes., Results: There was no difference in KSS scale between the graft group (64.4 ± 21.8 and the graftless group (61.6 ± 17.3; p= 0.309. There was no difference of angle between the femur and tibia in the frontal plane between the groups (graft, = 184 ± 4.6 degrees, graftless = 183.4 ± 5.1 degrees; p= 1.0, indicating that there is no loss of correction due to the lack of the graft. There was significant aggravation of osteoarthritis in a greater number of patients in a graft group (p= 0.005 . Conclusion: Autologous iliac bone graft does not improve clinical outcomes in medium and long-term follow-up of medial opening-wedge high tibial osteotomy fixed with a first generation Puddu plate in the conditions of this study.

World’s First Clinical Case of Gene-Activated Bone Substitute Application

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I. Y. Bozo

2016-01-01

Full Text Available Treatment of patients with large bone defects is a complex clinical problem. We have initiated the first clinical study of a gene-activated bone substitute composed of the collagen-hydroxyapatite scaffold and plasmid DNA encoding vascular endothelial growth factor. The first patient with two nonunions of previously reconstructed mandible was enrolled into the study. Scar tissues were excised; bone defects (5–14 mm between the mandibular fragments and nonvascularized rib-bone autograft were filled in with the gene-activated bone substitute. No adverse events were observed during 12 months of follow-up. In 3 months, the average density of newly formed tissues within the implantation zone was 402.21 ± 84.40 and 447.68 ± 106.75 HU in the frontal and distal regions, respectively, which correlated with the density of spongy bone. Complete distal bone defect repair with vestibular and lingual cortical plates formation was observed in 6 and 12 months after surgery; thereby the posterior nonunion was successfully eliminated. However, there was partial resorption of the proximal edge of the autograft entailed to relapse of the anterior nonunion. Thus, the first clinical data on the safety and efficacy of the gene-activated bone substitute were obtained. Given a high complexity of the clinical situation the treatment, results might be considered as promising. NCT02293031.

Development of a Three-Dimensional (3D) Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft

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Chou, Ying-Chao; Lee, Demei; Chang, Tzu-Min; Hsu, Yung-Heng; Yu, Yi-Hsun; Liu, Shih-Jung; Ueng, Steve Wen-Neng

2016-01-01

This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D) printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire) fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft. PMID:27104525

Development of a Three-Dimensional (3D Printed Biodegradable Cage to Convert Morselized Corticocancellous Bone Chips into a Structured Cortical Bone Graft

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Ying-Chao Chou

2016-04-01

Full Text Available This study aimed to develop a new biodegradable polymeric cage to convert corticocancellous bone chips into a structured strut graft for treating segmental bone defects. A total of 24 adult New Zealand white rabbits underwent a left femoral segmental bone defect creation. Twelve rabbits in group A underwent three-dimensional (3D printed cage insertion, corticocancellous chips implantation, and Kirschner-wire (K-wire fixation, while the other 12 rabbits in group B received bone chips implantation and K-wire fixation only. All rabbits received a one-week activity assessment and the initial image study at postoperative 1 week. The final image study was repeated at postoperative 12 or 24 weeks before the rabbit scarification procedure on schedule. After the animals were sacrificed, both femurs of all the rabbits were prepared for leg length ratios and 3-point bending tests. The rabbits in group A showed an increase of activities during the first week postoperatively and decreased anterior cortical disruptions in the postoperative image assessments. Additionally, higher leg length ratios and 3-point bending strengths demonstrated improved final bony ingrowths within the bone defects for rabbits in group A. In conclusion, through this bone graft converting technique, orthopedic surgeons can treat segmental bone defects by using bone chips but with imitate characters of structured cortical bone graft.

Zygomatic bone graft for oral-antral communication closure and implant placement.

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Peñarrocha-Diago, Miguel; García, Berta; Gomez, Dolores; Balaguer, José

2007-01-01

The roots of molar and premolar maxillary teeth are often very close to the floor of the maxillary sinus. As a result, extraction of these teeth can leave an oral-antral communication or lead to a fistula that requires treatment. A woman with an oral-antral communication secondary to extraction of a maxillary molar is presented. The communication was closed by means of a bone graft harvested from the wall of the sinus (zygomatic bone). After 3 months, 2 dental implants were placed, one in the pterygoid area and the other with parasinusal angulation. Rehabilitation followed in the form of a screw-retained, fixed prosthesis 3 months after implant placement. There have been no complications after 1 year of follow-up. This surgical technique allowed closure of an oral-antral communication produced by molar extraction through placement of a zygomatic bone graft and subsequent placement of 2 dental implants.

Fresh-frozen bone: case series of a new grafting material for sinus lift and immediate implants.

LENUS (Irish Health Repository)

Viscioni, A

2010-08-01

Although autologous bone is considered to be the gold standard grafting material, it needs to be harvested from patients, a process that can be off-putting and can lead to donor site morbidity. For this reason, homologous fresh-frozen bone (FFB) was used in the current study as an alternative graft material.

Indirect MR-arthrography in osteochondral autograft and crushed bone graft with a collagen membrane-Correlation with histology

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Streitparth, F. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany)], E-mail: florian.streitparth@charite.de; Schoettle, P.; Schell, H. [Center for Musculoskeletal Surgery, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Lehmkuhl, L.; Madej, T.; Wieners, G. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Duda, G.N. [Center for Musculoskeletal Surgery, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany); Schroeder, R.J. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-University, Berlin (Germany)

2009-04-15

Objective: To analyze the spectrum of findings in indirect MR-arthrography following osteochondral autograft transfer system (OATS) and crushed bone graft using a magnetic resonance imaging (MRI) scoring and grading system in relation to histology as the standard of reference. Materials and methods: Iatrogenic lesions were set at ovine condylar facets (n = 6/group), treated with OATS or crushed bone graft. 1.5 T MRI was performed 6 months after surgery using PD-weighted (w fat saturated (fs) fast spin echo (FSE), T1-w 2D, and 3D fs gradient echo (GE) sequences 30 min. after i.v. Gd-DTPA administration and passive joint exercise. The repair tissue was evaluated by two independent radiologists. The MR findings were compared to histology. Results: In all cases, MRI and histologic grading correlated well and showed significant superior repair in OATS at 6 months (p < 0.05), reproducing the original articular contour and a good subchondral restoration. FsT1-w3DGE proved most appropriate identifying characteristic post-operative findings: the OATS group demonstrated bone marrow edema at the donor site and the graft/host interface showed significant enhancement in indirect MR-arthrography, indicating fibrocartilage. After crushed bone graft, we found an irregular structure and significant contrast uptake, consistent with remnants of bone grafts surrounded by inflammatory tissue. Conclusion: Indirect MR-arthrography is an accurate, non-invasive monitoring tool following OATS and crushed bone graft as the MRI scoring and grading system allows a reliable evaluation of normal and pathological osteochondral repair with a high histologic correlation.

Effects of bone substitute architecture and surface properties on cell response, angiogenesis, and structure of new bone

NARCIS (Netherlands)

Bobbert, F.S.L.; Zadpoor, A.A.

2017-01-01

The success of bone substitutes used to repair bone defects such as critical sized defects depends on the architecture of the porous biomaterial. The architectural parameters and surface properties affect cell seeding efficiency, cell response, angiogenesis, and eventually bone formation. The

Allogeneic versus autologous derived cell sources for use in engineered bone-ligament-bone grafts in sheep anterior cruciate ligament repair.

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Mahalingam, Vasudevan D; Behbahani-Nejad, Nilofar; Horine, Storm V; Olsen, Tyler J; Smietana, Michael J; Wojtys, Edward M; Wellik, Deneen M; Arruda, Ellen M; Larkin, Lisa M

2015-03-01

The use of autografts versus allografts for anterior cruciate ligament (ACL) reconstruction is controversial. The current popular options for ACL reconstruction are patellar tendon or hamstring autografts, yet advances in allograft technologies have made allogeneic grafts a favorable option for repair tissue. Despite this, the mismatched biomechanical properties and risk of osteoarthritis resulting from the current graft technologies have prompted the investigation of new tissue sources for ACL reconstruction. Previous work by our lab has demonstrated that tissue-engineered bone-ligament-bone (BLB) constructs generated from an allogeneic cell source develop structural and functional properties similar to those of native ACL and vascular and neural structures that exceed those of autologous patellar tendon grafts. In this study, we investigated the effectiveness of our tissue-engineered ligament constructs fabricated from autologous versus allogeneic cell sources. Our preliminary results demonstrate that 6 months postimplantation, our tissue-engineered auto- and allogeneic BLB grafts show similar histological and mechanical outcomes indicating that the autologous grafts are a viable option for ACL reconstruction. These data indicate that our tissue-engineered autologous ligament graft could be used in clinical situations where immune rejection and disease transmission may preclude allograft use.

The Effect of Liquid Nitrogen on Bone Graft Survival.

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Sirinoglu, Hakan; Çilingir, Özlem Tuğçe; Çelebiler, Ozhan; Ercan, Feriha; Numanoglu, Ayhan

2015-08-01

Liquid nitrogen is used in medicine for cancer treatment and tissue preservation; however, bone viability after its application is controversial. This study aims to evaluate both the tissue viability and the clinical and histopathologic findings following liquid nitrogen application with different thawing techniques in rats. Mandibular bone grafts were taken from 45 Wistar rats and freezed in liquid nitrogen for 20 minutes. In the rapid-thawing technique (Rapid Thawing-1, Rapid Thawing-2), the grafts were held for 20 minutes in room temperature; in the slow-thawing technique (Slow Thawing-1, Slow Thawing-2), 20 minutes in -20°C, 20 minutes in +4°C, and 20 minutes in room temperature, respectively. In Rapid Thawing-2 and Slow Thawing-2 groups, autografts were implanted to their origin for 3 weeks and bone staining with India ink was performed and samples taken for histologic examination. The amount of cells and blood vessels and the density of bone canaliculi were significantly reduced in Rapid Thawing-1 and Slow Thawing-1 groups comparing to the Control group. However, the reduction rate was more significant in the Slow Thawing-1 group. Histomorphometric evaluation of the healing autografts after 3 weeks revealed that the decreased amounts of canaliculi were not changed in Slow Thawing-2 group. The study results demonstrated that bone tissue survives after liquid nitrogen treatment regardless of the performed thawing technique; however, slow thawing causes more tissue damage and metabolism impairment. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Healing of extraction sockets filled with BoneCeramic® prior to implant placement: preliminary histological findings.

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De Coster, Peter; Browaeys, Hilde; De Bruyn, Hugo

2011-03-01

Various grafting materials have been designed to minimize edentulous ridge volume loss following tooth extraction by encouraging new bone formation in healing sockets. BoneCeramic® is a composite of hydroxyapatite and bèta-tricalcium phosphate with pores of 100-500 microns. The aim of this study was to evaluate bone regeneration in healing sockets substituted with BoneCeramic® prior to implant procedures. Fifteen extraction sockets were substituted with BoneCeramic® and 14 sockets were left to heal naturally in 10 patients (mean age 59.6 years). Biopsies were collected only from the implant recipient sites during surgery after healing periods ranging from 6-74 weeks (mean 22). In total, 24 biopsies were available; 10 from substituted and 14 from naturally healed sites. In one site, the implant was not placed intentionally and, in four substituted sites, implant placement had to be postponed due to inappropriate healing, hence from five sites biopsies were not available. Histological sections were examined by transmitted light microscope. At the time of implant surgery, bone at substituted sites was softer than in controls, compromising initial implant stability. New bone formation at substituted sites was consistently poorer than in controls, presenting predominantly loose connective tissue and less woven bone. The use of BoneCeramic® as a grafting material in fresh extraction sockets appears to interfere with normal healing processes of the alveolar bone. On the basis of the present preliminary findings, its indication as a material for bone augmentation, when implant placement is considered within 6-38 weeks after extraction, should be revised. © 2009, Copyright the Authors. Journal Compilation © 2011, Wiley Periodicals, Inc.

Autogenous bone graft and ePTFE membrane in the treatment of peri-implantitis. II. Stereologic and histologic observations in cynomolgus monkeys

DEFF Research Database (Denmark)

Schou, Søren; Holmstrup, Palle; Skovgaard, Lene Theil

2003-01-01

autogenous bone graft; guided bone regeneration; histology; membrane; non-human primates; oral implants; osseointegration; pathalogy; peri-implantitis; stereology; treatment......autogenous bone graft; guided bone regeneration; histology; membrane; non-human primates; oral implants; osseointegration; pathalogy; peri-implantitis; stereology; treatment...

A Prospective Study to Compare the Functional and Aesthetic Outcomes with and without Primary Bone Grafting in Facial Fractures

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Narayanamurthy Sundaramurthy

2017-10-01

Full Text Available Introduction: Open Reduction and Internal Fixation (ORIF has been the gold standard in treatment of facial fractures. Bone grafts have been used to correct bone defects in face. Many studies assessing outcomes of ORIF and primary bone grafting separately have been published in literature. Aim: A prospective study to compare the functional and aesthetic outcomes with and without primary bone grafting in facial fractures. Materials and Methods: Thirty patients, admitted between January 2012 and December 2013, were divided into two groups. Group 1 patients underwent ORIF with primary bone grafting and in group 2, only ORIF was done. Clinical and functional, photographic and radiological assessments were done after one month and three months. Results: Mean value of vertical dystopia in groups 1 and 2 after three months postoperatively were 1.25mm and 0.67mm. Mean value of enophthalmos in groups 1 and 2 after three months postoperatively were 0.5mm and 1mm. Thus, vertical dystopia was corrected better without bone grafts and enophthalmos corrected better with bone grafts. Photographic assessment revealed no statistical difference between the two groups. Postoperatively, in upper face fractures, both groups had similar number of patients in grades 1 and 2. Only one patient from group 2 of midface fractures ended up with grade 3 asymmetry. Radiologically, in upper face fractures, group 2 had more mean projection, height and breadth deficits (1.28mm, 2.57mm and 2.42mm when compared to group 1 (0.67mm, 1.50mm and 0.50mm. The mean projection and height deficits were statistically better in group 1. In midface fractures, mean zygomatic complex projection and height deficits were more in group 2 (1.88mm and 0.63mm than group 1 (0.78mm and 0.44mm. The mean zygomatic complex projection was statistically better in group1. Postoperative complications were lesser with the bone graft group. Conclusion: Judicious use of bone grafts in comminuted facial and orbital

Magnesium substitution in brushite cements for enhanced bone tissue regeneration

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Cabrejos-Azama, Jatsue, E-mail: jacaza@farm.ucm.es [Departamento de Química-Física II, Facultad de Farmacia, UCM, Madrid (Spain); Departamento de Estomatología III, Facultad de Odontología UCM, Madrid (Spain); Alkhraisat, Mohammad Hamdan; Rueda, Carmen [Departamento de Química-Física II, Facultad de Farmacia, UCM, Madrid (Spain); Torres, Jesús [Facultad de Ciencias de la salud URJC, Alcorcón, Madrid (Spain); Blanco, Luis [Departamento de Estomatología III, Facultad de Odontología UCM, Madrid (Spain); López-Cabarcos, Enrique [Departamento de Química-Física II, Facultad de Farmacia, UCM, Madrid (Spain)

2014-10-01

We have synthesized calcium phosphate cements doped with different amounts of magnesium (Mg-CPC) with a twofold purpose: i) to evaluate in vitro the osteoblast cell response to this material, and ii) to compare the bone regeneration capacity of the doped material with a calcium cement prepared without magnesium (CPC). Cell proliferation and in vivo response increased in the Mg-CPCs in comparison with CPC. The Mg-CPCs have promoted higher new bone formation than the CPC (p < 0.05). The cytocompatibility and histomorfometric analysis performed in the rabbit calvaria showed that the incorporation of magnesium ions in CPC improves osteoblasts proliferation and provides higher new bone formation. The development of a bone substitute with controllable biodegradable properties and improved bone regeneration can be considered a step toward personalized therapy that can adapt to patient needs and clinical situations. - Highlights: • The Mg-CPCs promote higher new bone formation than the CPC. • The incorporation of magnesium ions in CPC improves osteoblasts proliferation. • Mg-CPC is a bone substitute with controllable biodegradable properties. • We suggest that the use of Mg ions could improve the clinical efficiency of CPCs.

Bone augmentation procedures in localized defects in the alveolar ridge: clinical results with different bone grafts and bone-substitute materials

DEFF Research Database (Denmark)

Jensen, Simon Storgård; Terheyden, Hendrik

2009-01-01

PURPOSE: The objective of this review was to evaluate the efficacy of different grafting protocols for the augmentation of localized alveolar ridge defects. MATERIALS AND METHODS: A MEDLINE search and an additional hand search of selected journals were performed to identify all levels of clinical...... evidence except expert opinions. Any publication written in English and including 10 or more patients with at least 12 months of follow-up after loading of the implants was eligible for this review. The results were categorized according to the presenting defect type: (1) dehiscence and fenestration...... periods. The heterogeneity of the available data did not allow identifying one superior grafting protocol for any of the osseous defect types under investigation. However, a series of grafting materials can be considered well-documented for different indications based on this review. There is a high level...

An alternative graft fixation technique for scaphoid nonunions treated with vascular bone grafting.

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Korompilias, Anastasios V; Lykissas, Marios G; Kostas-Agnantis, Ioannis P; Gkiatas, Ioannis; Beris, Alexandros E

2014-07-01

To present our experience with vascularized bone grafting based on the 1,2-intercompartmental supraretinacular artery for the management of established scaphoid nonunion and to investigate the efficacy of graft immobilization with a combination of Kirschner wires and transarticular external fixation. A retrospective chart and radiographic review was conducted for patients with the diagnosis of scaphoid nonunion of the proximal pole or the waist treated with the 1,2-intercompartmental supraretinacular artery-based vascularized graft and fixed with a combination of Kirschner wires and transarticular external fixation between 2007 and 2011. We observed 23 consecutive patients for a mean of 34 ± 4 months. All patients were males with mean age of 25 ± 5 years. All patients had scaphoid nonunion and associated humpback deformity. The mean duration of nonunion was 7 ± 1 months. All scaphoid nonunions united after the index procedure at a mean of 10 ± 1 weeks. Two patients had avascular necrosis of the proximal pole based on the preoperative magnetic resonance imaging findings. After surgery, deformity correction was achieved in all patients, as recorded by the decrease in the lateral intrascaphoid angle and the increase in the dorsal scaphoid angle. At the last follow-up, no patients reported wrist pain. The mean Disabilities of the Arm, Shoulder, and Hand score improved significantly from 32 ± 12 before the operation to 5 ± 3 at the last postoperative visit. All patients showed statistically significant improvement in the range of motion and the grip strength of the involved wrist. The results of this study support the combined use of Kirschner wires and transarticular external fixation for fixation of a 1,2-intercompartmental supraretinacular artery-based vascular bone graft in the treatment of scaphoid nonunions. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Effects of LED phototherapy on bone defects grafted with MTA, bone morphogenetic proteins and guided bone regeneration: a Raman spectroscopic study.

Science.gov (United States)

Pinheiro, Antonio L B; Soares, Luiz G P; Cangussú, Maria Cristina T; Santos, Nicole R S; Barbosa, Artur Felipe S; Silveira Júnior, Landulfo

2012-09-01

We studied peaks of calcium hydroxyapatite (CHA) and protein and lipid CH groups in defects grafted with mineral trioxide aggregate (MTA) treated or not with LED irradiation, bone morphogenetic proteins and guided bone regeneration. A total of 90 rats were divided into ten groups each of which was subdivided into three subgroups (evaluated at 15, 21 and 30 days after surgery). Defects were irradiated with LED light (wavelength 850 ± 10 nm) at 48-h intervals for 15 days. Raman readings were taken at the surface of the defects. There were no statistically significant differences in the CHA peaks among the nonirradiated defects at any of the experimental time-points. On the other hand, there were significant differences between the defects filled with blood clot and the irradiated defects at all time-points (p Raman spectral analysis indicate that infrared LED light irradiation improves the deposition of CHA in healing bone grafted or not with MTA.

Histomorhological and clinical evaluation of maxillary alveolar ridge reconstruction after craniofacial trauma by applying combination of allogeneic and autogenous bone graft

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Francesco Saverio De Ponte

2017-02-01

Full Text Available A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a consequence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla.

Tissue reaction and material biodegradation of a calcium sulfate/apatite biphasic bone substitute in rat muscle

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Jian-Sheng Wang

2016-07-01

Conclusion: Calcium sulfate hydroxyapatite bone substitute can be used as a carrier for antibiotics or other drugs, without adverse reaction due to the fast resorption of the calcium sulfate. No bone formation was seen despite treating the bone substitute with autologous bone marrow.

Maxillary sinus lift with solely autogenous bone compared to a combination of autogenous bone and growth factors or (solely) bone substitutes. A systematic review : a systematic review

NARCIS (Netherlands)

Rickert, D.; Slater, J. J. R. Huddleston; Meijer, H. J. A.; Vissink, A.; Raghoebar, G. M.

Literature regarding the outcome of maxillary sinus floor elevation to create sufficient bone fraction to enable implant placement was systematically reviewed. Bone fraction and implant survival rate were assessed to determine whether grafting material or applied growth factor affected bone

Is dibotermin alfa a cost-effective substitute for autologous iliac crest bone graft in single level lumbar interbody spine fusion?

Science.gov (United States)

Svedbom, Axel; Paech, Daniel; Leonard, Catherine; Donnell, David; Song, Fujian; Boszcyk, Bronek; Rothenfluh, Dominique A; Lloyd, Andrew; Borgman, Benny

2015-11-01

To evaluate the cost-effectiveness of dibotermin alfa compared with autologous iliac crest bone graft (ICBG) for patients undergoing single level lumbar interbody spinal fusion in a UK hospital setting. An individual patient data (IPD) meta-analysis of six randomized controlled clinical trials and two single arm trials compared dibotermin alfa on an absorbable collagen implantation matrix (ACIM) (n = 456) and ICBG (n = 244) on resource use, re-operation rates, and SF-6D (Short form 6-dimension) health utility (total N = 700). Failure-related second surgery, operating time, post-operative hospital stay, and quality-adjusted life years (QALYs) derived from the IPD meta-analysis were included as inputs in an economic evaluation undertaken to assess the cost-effectiveness of dibotermin alfa/ACIM versus ICBG for patients undergoing single level lumbar interbody spinal fusion. A four year time horizon and the United Kingdom (UK) National Health Service (NHS) and Personal Social Services (PSS) perspective was adopted in the base case, with sensitivity analyses performed to gauge parameter uncertainty. In the base case analysis, patients treated using dibotermin alfa/ACIM (12 mg pack) accrued 0.055 incremental QALYs at an incremental cost of £ 737, compared with patients treated with ICBG. This resulted in an incremental cost-effectiveness ratio (ICER) of £ 13,523, indicating that at a willingness-to-pay threshold of £ 20,000, dibotermin alfa/ACIM is a cost-effective intervention relative to ICBG from the NHS and PSS perspective. In a UK hospital setting, dibotermin alfa/ACIM is a cost-effective substitute for ICBG for patients who require lumbar interbody arthrodesis.

Intraoperative fat embolism during core decompression and bone grafting for osteonecrosis of the hip: report of 3 cases and literature review.

Science.gov (United States)

Schaffer, Joseph Christopher; Adib, Farshad; Cui, Quanjun

2014-06-01

Osteonecrosis (ON) of the femoral head, without timely intervention, often progresses to debilitating hip arthritis. Core decompression (CD) with bone grafting was used to treat patients with early-stage ON. In 3 cases, intraoperative oxygen saturation, end-tidal carbon dioxide fluctuations, and/or vital sign fluctuations were observed during insertion of the graft, a mixture of bone marrow and demineralized bone matrix. In 1 case, continued postoperative pulmonary symptoms required admission to intensive care. In this article, we describe these cases and provide supporting evidence that they were caused by fat emboli secondary to forceful insertion of bone graft. We review the literature and present complications data. Although no cases of fat emboli were reported as complications of any CD series with or without bone grafting, CD augmented with bone graft may carry risks not seen before in CD alone. Care should be taken to avoid these complications, possibly through technique modification.

Decalcified allograft in repair of lytic lesions of bone: A study to evolve bone bank in developing countries

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Anil Kumar Gupta

2016-01-01

Full Text Available Background: The quest for ideal bone graft substitutes still haunts orthopedic researchers. The impetus for this search of newer bone substitutes is provided by mismatch between the demand and supply of autogenous bone grafts. Bone banking facilities such as deep frozen and freeze-dried allografts are not so widely available in most of the developing countries. To overcome the problem, we have used partially decalcified, ethanol preserved, and domestic refrigerator stored allografts which are economical and needs simple technology for procurement, preparation, and preservation. The aim of the study was to assess the radiological and functional outcome of the partially decalcified allograft (by weak hydrochloric acid in patients of benign lytic lesions of bone. Through this study, we have also tried to evolve, establish, and disseminate the concept of the bone bank. Materials and Methods: 42 cases of lytic lesions of bone who were treated by decalcified (by weak hydrochloric acid, ethanol preserved, allografts were included in this prospective study. The allograft was obtained from freshly amputated limbs or excised femoral heads during hip arthroplasties under strict aseptic conditions. The causes of lytic lesions were unicameral bone cyst ( n = 3, aneurysmal bone cyst ( n = 3, giant cell tumor ( n = 9, fibrous dysplasia ( n = 12, chondromyxoid fibroma, chondroma, nonossifying fibroma ( n = 1 each, tubercular osteomyelitis ( n = 7, and chronic pyogenic osteomyelitis ( n = 5. The cavity of the lesion was thoroughly curetted and compactly filled with matchstick sized allografts. Results: Quantitative assessment based on the criteria of Sethi et al. (1993 was done. There was complete assimilation in 27 cases, partial healing in 12 cases, and failure in 3 cases. Functional assessment was also done according to which there were 29 excellent results, 6 good, and 7 cases of failure (infection, recurrence, and nonunion of pathological fracture. We

Retrospective Analysis of the Outcome of Ridge Preservation with Anorganic Bovine Bone Minerals: Microcomputed Tomographic Assessment of Wound Healing in Grafted Extraction Sockets.

Science.gov (United States)

Bakhshalian, Neema; Freire, Marcelo; Min, Seiko; Wu, Ivy; Zadeh, Homayoun H

A total of 68 extraction sockets were grafted with anorganic bovine bone mineral and covered by dense polytetrafluoroethylene membrane. Quantitative analysis of three-dimensional microcomputed tomography imaging of core samples retrieved after a mean of 21.0 ± 14.2 weeks revealed 40.1% bone volume fraction (bone volume [BV]/total volume [TV]) and 12% residual graft. Evidence of de novo bone formation was observed in the form of discrete islands of newly formed bone in direct apposition to graft particles, separated from parent bone. Anterior sockets exhibited a significantly higher percentage of residual graft compared to premolar sockets (P = .05). The BV/TV and percentage of residual graft correlated well with histomorphometric analysis of the same sites, but not with implant outcomes.

Anatomical reconstruction of the fourth brachymetatarsia with one-stage iliac bone and cartilage cap grafting.

Science.gov (United States)

Woo, Sang Hyun; Bang, Chi Young; Ahn, Hee-Chan; Kim, Sung-Jung; Choi, Jun-Young

2017-05-01

We present a one-stage procedure for lengthening the fourth brachymetatarsia with autogenous iliac bone and cartilage cap grafting for the anatomical reconstruction of the metatarsophalangeal (MTP) joint METHODS: During the last 8 years, 56 feet in 41 patients with congenital brachymetatarsia of the fourth toe were corrected with a one-stage operation to reposition the articular cartilage cap to the distal part of interpositional iliac bone graft at the metatarsal epiphysis. The length of the harvested iliac bone graft was 22.9 mm on average. The mean fixation period was 58.5 days, and the mean gain in length and percentage increase was 20.9 mm and 39%, respectively. MRI showed a stable MTP joint over viable cartilage cap in 83.3% of the cases. Mean postoperative American Orthopedic Foot and Ankle Society lesser MTP-interphalangeal score was 82.0. Neither neurovascular impairment nor recurrence of brachymetatarsia occurred in the mean follow-up period of 43.6 months. All patients were satisfied with the postoperative cosmetic results. Thirteen patients (23.2%) complained of limited active dorsiflexion of the fourth toe, and extensor adhesion was released by extensor tenolysis in only one patient. In a single case of nonunion at the bone graft site, additional surgery was not necessary. Anatomical reconstruction of the fourth brachymetatarsia with one-stage interpositional iliac bone and cartilage cap grafting resulted in excellent cosmetic results and a physiologic MTP joint, providing the benefits of one-stage lengthening with a low complication rate. Therapeutic, IV. Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Macroporous synthetic hydroxyapatite bioceramics for bone substitute applications

CSIR Research Space (South Africa)

Thomas, ME

1999-08-01

Full Text Available An improved strategy is described for the manufacture of macroporous hydroxyapatite bioceramics for bone substitute applications. This is based on a modified fugitive phase technique, which allows production of relatively open, high-strength devices...

Maxillary sinus floor augmentation with Bio-Oss or Bio-Oss mixed with autogenous bone as graft in animals

DEFF Research Database (Denmark)

Jensen, T; Schou, S; Stavropoulos, Andreas

2012-01-01

The objective of the present systematic review was to test the hypothesis of no differences between the use of Bio-Oss or Bio-Oss mixed with autogenous bone as graft for maxillary sinus floor augmentation (MSFA) applying the lateral window technique, as evaluated in animals. A MEDLINE (Pub...... of the graft improved significantly with increased proportion of Bio-Oss. Bone regeneration, bone-to-implant contact (BIC), biomechanical implant test values, and biodegradation of Bio-Oss after MSFA with Bio-Oss or Bio-Oss mixed with autogenous bone have never been compared within the same study in animals....... Thus, the hypothesis of no differences between the use of Bio-Oss and Bio-Oss mixed with autogenous bone as graft for MSFA could neither be confirmed nor rejected based on existing animal studies....

Expression of bone morphogenic protein 2/4, transforming growth factor-β1, and bone matrix protein expression in healing area between vascular tibia grafts and irradiated bone-experimental model of osteonecrosis

International Nuclear Information System (INIS)

Schultze-Mosgau, Stefan; Lehner, Bernhard; Roedel, Franz; Wehrhan, Falk; Amann, Kerstin; Kopp, Juergen; Thorwarth, Michael; Nkenke, Emeka; Grabenbauer, Gerhard

2005-01-01

Purpose: For the surgical treatment of osteoradionecrosis after multimodal therapy of head-and-neck cancers, free vascular bone grafts are used to reconstruct osseous structures in the previously irradiated graft bed. Reduced, or even absent osseous healing in the transition area between the vascular graft and the irradiated graft bed represents a clinical problem. Inflammatory changes and fibrosis lead to delayed healing, triggered by bone morphogentic protein 2/4 (BMP2/4) and transforming growth factor (TGF)-β 1 . Given the well-known fibrosis-inducing activity of TGF-β 1 , an osteoinductive effect has been reported for BMP2/4. However, the influence of irradiation (RT) on this cytokine expression remains elusive. Therefore, the aim of the present in vivo study was to analyze the expression of BMP2/4, TGF-β 1 , collagen I, and osteocalcin in the transition area between the bone graft and the graft bed after RT. Methods and materials: Twenty Wistar rats (male, weight 300-500 g) were used in this study. A free vascular tibia graft was removed in all rats and maintained pedicled in the groin region. Ten rats underwent RT with 5 x 10 Gy to the right tibia, the remainder served as controls. After 4 weeks, the previously removed tibia grafts were regrafted into the irradiated (Group 1) and nonirradiated (Group 2) graft beds. The interval between RT and grafting was 4 weeks. After a 4-week osseous healing period, the bone grafts were removed, and the transition area between the nonirradiated graft and the irradiated osseous graft bed was examined histomorphometrically (National Institutes of Health imaging program) and immunohistochemically (avidin-biotin-peroxidase complex) for the expression of BMP2/4, TGF-β 1 , collagen I, and osteocalcin. Results: Absent or incomplete osseous healing of the graft was found in 9 of 10 rats after RT with 50 Gy and in 1 of 10 of the rats with nonirradiated osseous grafts. Histomorphometrically, the proportion of osseous healing in

Advances in allogenic bone graft processing and usage: preparation and evaluation of chitosan-demineralized cancellous bone powder composite scaffolds as a bone graft substitute

International Nuclear Information System (INIS)

Yongyudh Vajaradul

2008-01-01

Full text: Demineralized bone matrix (DBM) is currently used by surgeons. It usually exists as a lyophilized powder which is difficult to handle and operated. In this study, we try to improve these disadvantages by combining DBM with a biomaterial. It focuses on a natural biodegradable polymer, chitosan, to act as a temporary matrix for bone growth that easily prepare in any size and shape by using tissue engineering knowledge to get a proper temporary matrix. Thus, the development of chitosan-demineralized bone powder composite scaffold is an alternative way. Polymeric scaffold has been demonstrated to have great potential for tissue engineering because the scaffold or three dimension (3D) construct provides the necessary support for cells to proliferate, extracellular matrix deposition and vascularization of neo-tissue. Moreover, chitosan, a natural cationic polymer which its structural is similar to extracellular matrix glycosaminoblycans, is biodegradable, biocompatible, non-antigenic and biofunctional. It can enhance osteoblast cells proliferation and mineral matrix deposition in culture. The first study was to fabricate and analyze composite scaffold composed of either chitosan-demineralized cancellous bone powders or chitosan-demineralized cancellous cartilage bone powders in a ratio 50:50 and 70:30 w/w (chitosan : bone powders) based on physical properties composing of average pore diameter, mechanical integrity and swelling property. Secondly, scaffolds were evaluated in term of biological properties composing of their ability to support neo osteogenesis, including assessments of cell attachment and viability, cell morphology, and the biosynthesis of extracellular matrix. Results indicated that chitosan-demineralized cancellous bone powder composite scaffolds possessing an interconnecting, porous structure could be easily created through a simple freezing and lyophilization process. (Author)

Histomorhological and clinical evaluation of maxillary alveolar ridge reconstruction after craniofacial trauma by applying combination of allogeneic and autogenous bone graft.

Science.gov (United States)

De Ponte, Francesco Saverio; Falzea, Roberto; Runci, Michele; Siniscalchi, Enrico Nastro; Lauritano, Floriana; Bramanti, Ennio; Cervino, Gabriele; Cicciu, Marco

2017-02-01

A variety of techniques and materials for the rehabilitation and reconstruction of traumatized maxillary ridges prior to dental implants placement have been described in literature. Autogenous bone grafting is considered ideal by many researchers and it still remains the most predictable and documented method. The aim of this report is to underline the effectiveness of using allogeneic bone graft for managing maxillofacial trauma. A case of a 30-year-old male with severely atrophic maxillary ridge as a consequence of complex craniofacial injury is presented here. Augmentation procedure in two stages was performed using allogeneic and autogenous bone grafts in different areas of the osseous defect. Four months after grafting, during the implants placement surgery, samples of both sectors were withdrawn and submitted to histological evaluation. On the examination of the specimens, treated by hematoxylin and eosin staining, the morphology of integrated allogeneic bone grafts was revealed to be similar to the autologous bone. Our clinical experience shows how the allogeneic bone graft presented normal bone tissue architecture and is highly vascularized, and it can be used for reconstruction of severe trauma of the maxilla. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

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D D Baksi

2016-01-01

Full Text Available Background: Ununited femoral neck fracture is seen commonly in developing countries due to delayed presentation or failure of primary internal fixation. Such fractures, commonly present with partial or total absorption of femoral neck, osteonecrosis of femoral head in 8-30% cases with upward migration of trochanter posing problem for osteosynthesis, especially in younger individuals. Several techniques for treatment of such conditions are described like osteotomies or nonvascularied cortical or cancellous bone grafting provided varying degrees of success in terms of fracture union but unsatisfactory long term results occurred due to varying incidence of avascular necrosis (AVN of femoral head. Moreover, in presence of AVN of femoral head neither free fibular graft nor cancellous bone graft is satisfactory. The vascularied bone grafting by deep circumflex iliac artery based on iliac crest bone grafting, free vascularied fibular grafting and muscle pedicle periosteal grafting showed high incidence of success rate. Osteosynthesis is the preferred treatment of choice in ununited femoral neck fracture in younger individuals. Materials and Methods: Of the 293 patients operated during the period from June 1977 to June 2009, 42 were lost to followup. Seven patients with gluteus medius muscle pedicle bone grafting (MPBG were excluded. Thus, out of 244 patients, 208 (85.3% untreated nonunion and 36 (14.7% following failure of primary internal fixation were available for studies. Time interval between the date of injury and operation in untreated nonunion cases was mean 6.5 months and in failed internal fixation cases was mean 11.2 months. Ages of the patients varied from 16 to 55 years. Seventy patients had partial and 174 had subtotal absorption of the femoral neck. Evidence of avascular necrosis (AVN femoral head was found histologically in 135 (54.3% and radiologically in 48 (19.7% patients. The patients were operated by open reduction of fracture

Porous bioresorbable magnesium as bone substitute

Energy Technology Data Exchange (ETDEWEB)

Wen, C.E.; Yamada, Y.; Shimojima, K.; Chino, Y.; Hosokawa, H.; Mabuchi, M. [Inst. for Structural and Engineering Materials, National Inst. of Advanced Industrial Science and Technology, Nagoya (Japan)

2003-07-01

Recently magnesium has been recognized as a very promising biomaterial for bone substitutes because of its excellent properties of biocompatibility, biodegradability and bioresorbability. In the present study, magnesium foams were fabricated by using a powder metallurgical process. Scanning electron microscopy equipped with energy dispersive X-ray spectrometer (EDS) and compressive tester were used to characterize the porous magnesium. Results show that the Young's modulus and the peak stress of the porous magnesium increase with decreasing porosity and pore size. This study suggests that the mechanical properties of the porous magnesium with the low porosity of 35% and/or with the small pore size of about 70 {mu}m are close to those of human cancellous bones. (orig.)

Characterization of powdered fish heads for bone graft biomaterial applications.

Science.gov (United States)

Oteyaka, Mustafa Ozgür; Unal, Hasan Hüseyin; Bilici, Namık; Taşçı, Eda

2013-01-01

The aim of this study was to define the chemical composition, morphology and crystallography of powdered fish heads of the species Argyrosomus regius for bone graft biomaterial applications. Two sizes of powder were prepared by different grinding methods; Powder A (coarse, d50=68.5 µm) and Powder B (fine, d50=19.1 µm). Samples were analyzed using X-ray diffraction (XRD), X-ray fluorescence (XRF), scanning electron microscopy (SEM), thermogravimetry (TG), and energy dispersive X-ray spectroscopy (EDS). The powder was mainly composed of aragonite (CaCO3) and calcite (CaCO3). The XRD pattern of Powder A and B matched standard aragonite and calcite patterns. In addition, the calcium oxide (CaO) phase was found after the calcination of Powder A. Thermogravimetry analysis confirmed total mass losses of 43.6% and 47.3% in Powders A and B, respectively. The microstructure of Powder A was mainly composed of different sizes and tubular shape, whereas Powder B showed agglomerated particles. The high quantity of CaO and other oxides resemble the chemical composition of bone. In general, the powder can be considered as bone graft after transformation to hydroxyapatite phase.

Evaluation of the incorporation of bone grafts used in maxillofacial surgery with [18F]fluoride ion and dynamic positron emission tomography

International Nuclear Information System (INIS)

Berding, G.; Burchert, W.; Hoff, J. van den; Pytlik, C.; Neukam, F.W.; Meyer, G.J.; Gratz, K.F.; Hundeshagen, H.

1995-01-01

This study investigates the incorporation of bone grafts used in maxillofacial surgery by means of 18 F-fluoride ion and PET. It considers patients who received pedicle grafts for mandibular reconstruction or onlay grafts for alveolar ridge augmentation. Dynamic PET images and arterialized venous blood samples were obtained within a 1-h period after i.v. injection of 18 F-fluoride. Assuming a three-compartment model and applying multilinear least squares fitting, bone blood flow and fluoride influx (K mlf ) were determined. Additionally Patlak plot analysis was used to calculate fluoride influx (K pat ). Early after surgery a significant increase in flow and influx compared to vertebral bodies was observed in the regions of osteosyntheses between grafts used for reconstruction and recipient bone. At the same time pedicle grafts showed a significant increase in flow but not in influx. Furthermore K pat was significantly lower in pedicle grafts than in onlay grafts. In follow-up studies a significant decrease in flow occurred in pedicle grafts and the regions of osteosyntheses. Moreover the latter showed a significant decrease in K mlf as well. It is concluded that 18 F - PET depicted increased blood flow and osteoblastic activity in onlay grafts and regions of osteosyntheses, indicating bone repair in the graft and adjacent host bone early after surgery. For the regions of osteosyntheses the decrease in both parameters corresponded to uncomplicated healing. The lack of increased influx, although flow was increased in pedicle grafts, most likely indicates that some necrosis occurred in these grafts despite patency of anastomoses. It may be concluded that 18 F - PET provides further insight into the biology of graft incorporation. (orig./MG)

Treatment of midshaft clavicular nonunion with plate fixation and autologous bone grafting

DEFF Research Database (Denmark)

Olsen, Bo Sanderhoff; Vaesel, M T; Søjbjerg, Jens Ole

1995-01-01

We studied the results of 16 consecutive midshaft clavicular nonunions operated on at the Shoulder and Elbow Clinic during the period from 1990 to 1993. All patients were treated with rigid 3.5 mm plate fixation and autologous cancellous bone grafting. Union of the fractures was achieved in all...... except one case, with a reconstruction ratio (restoration of bone length) of 0.96 (range 0.88 to 1.03). At follow-up 12 of 16 patients had returned to their preinjury activity level and according to the Constant score had obtained an excellent result. Two patients were graded as good, one as fair......, and one had a failure. Thirteen of 16 patients were satisfied with the cosmetic outcome, assessing their cosmetic result as either good or excellent. Rigid plate fixation and restoration of clavicular length with autologous cancellous bone graft is recommended for the treatment of symptomatic clavicular...

Preoperative implant planning considering alveolar bone grafting needs and complication prediction using panoramic versus CBCT images

Energy Technology Data Exchange (ETDEWEB)

Guerrero, Maria Eugenia; Jacobs, Reinhilde [OIC, OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven, Leuven (Belgium); Noriega, Jorge [Master of Periodontology, Universidad San Martin de Porres, Lima (Peru)

2014-09-15

This study was performed to determine the efficacy of observers' prediction for the need of bone grafting and presence of perioperative complications on the basis of cone-beam computed tomography (CBCT) and panoramic radiographic (PAN) planning as compared to the surgical outcome. One hundred and eight partially edentulous patients with a need for implant rehabilitation were referred for preoperative imaging. Imaging consisted of PAN and CBCT images. Four observers carried out implant planning using PAN image datasets, and at least one month later, using CBCT image datasets. Based on their own planning, the observers assessed the need for bone graft augmentation as well as complication prediction. The implant length and diameter, the need for bone graft augmentation, and the occurrence of anatomical complications during planning and implant placement were statistically compared. In the 108 patients, 365 implants were installed. Receiver operating characteristic analyses of both PAN and CBCT preoperative planning showed that CBCT performed better than PAN-based planning with respect to the need for bone graft augmentation and perioperative complications. The sensitivity and the specificity of CBCT for implant complications were 96.5% and 90.5%, respectively, and for bone graft augmentation, they were 95.2% and 96.3%, respectively. Significant differences were found between PAN-based planning and the surgery of posterior implant lengths. Our findings indicated that CBCT-based preoperative implant planning enabled treatment planning with a higher degree of prediction and agreement as compared to the surgical standard. In PAN-based surgery, the prediction of implant length was poor.

Total lymph-node irradiation and pretreatment with cyclophosphamide in preparation for bone-marrow grafting for aplastic anaemia

International Nuclear Information System (INIS)

Jansen, J.; Zwaan, F.E.; Noordijk, E.M.

1981-01-01

Bone-marrow transplantation (BMT), using bone marrow from an HLA-identical brother or sister constitutes the treatment of choice in most young patients with severe aplastic amaemia. The cases are described of 6 patients who were prepared for grafting by administration of cyclophosphamide (4 days, 50 mg/kg body weight day) and total lymph-node irradiation (750 rad in a single dose). One patient died on the 26th day after BMT from a disseminated Aspergillus infection, and another on the 28th day from the consequences of graft-versus-host disease (GVH disease). One patient recovered after an episode of GVH disease. Two patients developed no complications after the grafting. One female patient, who for the lack of an HLA-identical brother or sister had been grafted with bone marrow of her father whose HLA-phenotype was identical, was normalized haematologically but developed chronic GVH disease of the skin. This method of preparation for BMT for aplastic anaemia reduces the risk of rejection of the bone marrow to a minimum, and may well reduce the frequency and severity of GVH disease. (Auth.)

Computed tomography to evaluate the association of fragmented heterolog cortical bone and methylmethacrylate to repare segmental bone defect produced in tibia of rabbits; Tomografia computadorizada da matriz ossea mineralizada heterologa fragmentada e metilmetacrilato na reparacao de falhas osseas segmentares produzidas em tibia de coelhos

Energy Technology Data Exchange (ETDEWEB)

Freitas, S.H. [Universidade Federal de Sao Paulo (USP), SP (Brazil); Doria, R.G.S. [Universidade Federal de Sao Paulo (USP), SP (Brazil). Faculdade de Zootecnia e Engenharia de Alimentos; Mendonca, F.S.; Santos, M.D.; Moreira, R. [Universidade de Cuiaba, MT (Brazil). Faculdade de Medicina Veterinaria; Simoes, R.S. [Universidade Federal de Sao Paulo (USP), SP (Brazil). Hospital Universitario; Camargo, L.M.; Simoes, M.J. [Universidade Federal de Sao Paulo (USP), SP (Brazil). Escola Paulista de Medicina; Marques, A.T.C. [Universidade de Cuiaba, MT (Brazil). Faculdade de Odontologia

2012-11-15

A 6mm segmental defect was performed on the metaphyseal region of the tibia of 12 rabbits and the autoclaved fragmented heterolog cortical bone conserved in glycerin (98%) and methylmethacrylate was used as a bone graft for the reconstruction. The graft was placed in the receptor bed and its integration was evaluated by computed tomography after 30, 60 and 90 days. There was gradual bone graft incorporation in the receptor bed during the time in 100% of the cases. Fragmented cortical bone heterograft and methylmethacrylate was biologically compatible and promotes bone defect reparation without signs of infection, migration and or rejection, featuring a new option of osseous substitute to fill in bone defects. (author)

Sinus Floor Elevation and Augmentation Using Synthetic Nanocrystalline and Nanoporous Hydroxyapatite Bone Substitute Materials: Preliminary Histologic Results.

Science.gov (United States)

Belouka, Sofia-Maria; Strietzel, Frank Peter

To compare the tissue composition of augmented sites after using two different synthetic bone substitute materials, nanocrystalline and nanoporous hydroxyapatite (HA), for sinus floor elevation and augmentation. Forty-four patients received 88 titanium screw implants (Camlog Promote plus) of 4.3-mm diameter and 11- or 13-mm length, placed simultaneously during sinus floor elevation and augmentation. Nanocrystalline (Ostim) or nanoporous (NanoBone) HA were used exclusively. Bone substitute materials and implant lengths were allocated by randomization. Bone biopsy specimens were obtained from the former area of the lateral access window at implant exposure during healing abutment placement after 6 months. Biopsy specimens were prepared and examined histologically and histomorphometrically. All implants were osseointegrated at the time of exposure. Clinically and histologically, no signs of inflammation in the augmented sites were present. The histomorphometric analysis of 44 biopsy specimens revealed 31.8% ± 11.6% newly formed bone for sites augmented with nanocrystalline HA and 34.6% ± 9.2% for nanoporous HA (P = .467). The proportion of remaining bone substitute material was 28.4% ± 18.6% and 30% ± 13%, respectively (P = .453). The proportion of soft tissue within the biopsy specimens was 39.9% ± 11.1% and 35.4% ± 6.8%, respectively (P = .064). No significant differences were found between the area fractions of bone, bone substitute material, and soft tissue concerning the bone substitute material utilized. Within the present study, both synthetic bone substitute materials, nanocrystalline and nanoporous HA, were found to support bone formation in sinus floor elevation and augmentation procedures by osteoconductivity. They were not completely resorbed after 6 months. The amounts of newly formed bone, soft tissue, and bone substitute material remnants were found to be similar, indicating that both materials are likewise suitable for sinus floor elevation and

Biological Evaluation of Flexible Polyurethane/Poly l-Lactic Acid Composite Scaffold as a Potential Filler for Bone Regeneration

Directory of Open Access Journals (Sweden)

Yuk Fai Lui

2017-09-01

Full Text Available Degradable bone graft substitute for large-volume bone defects is a continuously developing field in orthopedics. With the advance in biomaterial in past decades, a wide range of new materials has been investigated for their potential in this application. When compared to common biopolymers within the field such as PLA or PCL, elastomers such as polyurethane offer some unique advantages in terms of flexibility. In cases of bone defect treatments, a flexible soft filler can help to establish an intimate contact with surrounding bones to provide a stable bone-material interface for cell proliferation and ingrowth of tissue. In this study, a porous filler based on segmented polyurethane incorporated with poly l-lactic acid was synthesized by a phase inverse salt leaching method. The filler was put through in vitro and in vivo tests to evaluate its potential in acting as a bone graft substitute for critical-sized bone defects. In vitro results indicated there was a major improvement in biological response, including cell attachment, proliferation and alkaline phosphatase expression for osteoblast-like cells when seeded on the composite material compared to unmodified polyurethane. In vivo evaluation on a critical-sized defect model of New Zealand White (NZW rabbit indicated there was bone ingrowth along the defect area with the introduction of the new filler. A tight interface formed between bone and filler, with osteogenic cells proliferating on the surface. The result suggested polyurethane/poly l-lactic acid composite is a material with the potential to act as a bone graft substitute for orthopedics application.

Artificial Dermis Graft on the Mandible Lacking Periosteum After Excision of an Ossifying Fibroma: A Case Report

Directory of Open Access Journals (Sweden)

Chun-Ming Chen

2007-07-01

Full Text Available Collagen-based grafts have often been used as artificial tissue substitutes for the repair of tissue and organ defects. It is common surgical knowledge that autogenous or artificial skin grafts take well on the intact periosteum of bone. However, many experienced surgeons indicate that auto-genous or artificial skin grafts subsist poorly on the bone surface without periosteum. Therefore, primary closure is usually recommended in the wound healing of exposed bone. Vestibuloplasty might be needed to create enough depth of vestibule in the future. In this case report, we describe a peripheral ossifying fibroma surgically excised leaving a bony defect, which was covered by a piece of artificial dermis. Satisfactory result of the repaired surgical defect showed no need of vestibuloplasty after 6 years of follow-up.

Effects of a perfusion bioreactor activated novel bone substitute in spine fusion in sheep

DEFF Research Database (Denmark)

Sørensen, Jesper Roed; Koroma, Kariatta Ester; Ding, Ming

2012-01-01

To evaluate the effect of a large perfusion-bioreactor cell-activated bone substitute, on a two-level large posterolateral spine fusion sheep model.......To evaluate the effect of a large perfusion-bioreactor cell-activated bone substitute, on a two-level large posterolateral spine fusion sheep model....

Bone Metabolism after Total Hip Revision Surgery with Impacted Grafting: Evaluation using H215O and [18F]fluoride PET; A Pilot Study

NARCIS (Netherlands)

Temmerman, Olivier; Raijmakers, Pieter; Heyligers, Ide; Comans, Emile; Lubberink, Mark; Teule, Gerrit; Lammertsma, Adriaan

2008-01-01

Purpose: To evaluate bone blood flow and bone formation in patients after total hip revision surgery with impacted bone grafting using H2 15O and [18F]fluoride positron emission tomography (PET). Procedures: To asses bone blood flow and bone metabolism in bone allograft after impaction grafting,

Allograft tolerance in pigs after fractionated lymphoid irradiation. II. Kidney graft after conventional total lymphoid irradiation and bone marrow cell grafting

International Nuclear Information System (INIS)

Fradelizi, D.; Mahouy, G.; de Riberolles, C.; Lecompte, Y.; Alhomme, P.; Douard, M.C.; Chotin, G.; Martelli, H.; Daburon, F.; Vaiman, M.

1981-01-01

Experiments with pigs have been performed in order to establish bone marrow chimerism and kidney graft tolerance between SLA genotyped semi-incompatible animals. Recipients were conditioned by means of conventional fractionated total lymphoid irradiation (TLI) delivered by a vertical cobalt source. The principal lymphoid regions of the pig, including thymus and spleen, were submitted to irradiation. Two protocols were tested: A = 250 cGy four times a week x 13 times (TLI) (two animals) and B = 350 cGy three times a week x 8 times (TLI) (four animals). Bone marrow cells were injected 24 h after the last irradiation. One day later, bilateral nephrectomy and the graft of one kidney from the bone marrow cell donor were performed simultaneously. Results convinced us that application of the TLI protocol to humans is not yet practicable and that further experimental work is needed

The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants in sheep

DEFF Research Database (Denmark)

Babiker, Hassan

  The effect of Hydroxyapatite/collagen I composites, bone marrow aspirate and bone graft on fixation of bone implants IN SHEEP   Ph.D. Student, Hassan Babiker; Associate Professor, Ph.D. Ming Ding; Professor, dr.med., Soren Overgaard. Department of Orthopaedic Surgery, Odense University Hospital......, Odense, Denmark   Background: Hydroxyapatite and collagen composites (HA/coll) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effect of newly developed HA/coll-composites with and without bone marrow aspirate (BMA) in order to enhance the fixation...... of bone implants.   Materials and Methods: Titanium alloy implants were inserted into bilateral femoral condyles of 8 skeletally mature sheep, four in each sheep. The implant has a circumferential gap of 2 mm. The gap was filled with: HA/coll; HA/coll-BMA; autograft or allograft. Allograft was served...

In Vivo Bone Formation Within Engineered Hydroxyapatite Scaffolds in a Sheep Model.

Science.gov (United States)

Lovati, A B; Lopa, S; Recordati, C; Talò, G; Turrisi, C; Bottagisio, M; Losa, M; Scanziani, E; Moretti, M

2016-08-01

Large bone defects still represent a major burden in orthopedics, requiring bone-graft implantation to promote the bone repair. Along with autografts that currently represent the gold standard for complicated fracture repair, the bone tissue engineering offers a promising alternative strategy combining bone-graft substitutes with osteoprogenitor cells able to support the bone tissue ingrowth within the implant. Hence, the optimization of cell loading and distribution within osteoconductive scaffolds is mandatory to support a successful bone formation within the scaffold pores. With this purpose, we engineered constructs by seeding and culturing autologous, osteodifferentiated bone marrow mesenchymal stem cells within hydroxyapatite (HA)-based grafts by means of a perfusion bioreactor to enhance the in vivo implant-bone osseointegration in an ovine model. Specifically, we compared the engineered constructs in two different anatomical bone sites, tibia, and femur, compared with cell-free or static cell-loaded scaffolds. After 2 and 4 months, the bone formation and the scaffold osseointegration were assessed by micro-CT and histological analyses. The results demonstrated the capability of the acellular HA-based grafts to determine an implant-bone osseointegration similar to that of statically or dynamically cultured grafts. Our study demonstrated that the tibia is characterized by a lower bone repair capability compared to femur, in which the contribution of transplanted cells is not crucial to enhance the bone-implant osseointegration. Indeed, only in tibia, the dynamic cell-loaded implants performed slightly better than the cell-free or static cell-loaded grafts, indicating that this is a valid approach to sustain the bone deposition and osseointegration in disadvantaged anatomical sites.

Comparison of efficacies of different bone substitutes adhered to osteoblasts with and without extracellular matrix proteins

Directory of Open Access Journals (Sweden)

Li-Ling Tseng

2013-12-01

Conclusion: The results indicated that ECM proteins increased cell attachment to bone substitutes in vitro. The preferential affinity of different bone substitutes to certain ECM proteins was evident. Cerasorb and BoneCeramic had better MG63 human osteosarcoma cell adhesion ability than Bio-Oss and MBCP.

Comparative Biomechanical and Microstructural Analysis of Native versus Peracetic Acid-Ethanol Treated Cancellous Bone Graft

Science.gov (United States)

Rauh, Juliane; Despang, Florian; Baas, Jorgen; Liebers, Cornelia; Pruss, Axel; Günther, Klaus-Peter; Stiehler, Maik

2014-01-01

Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE) treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG). Forty-eight human CBG cylinders were either treated by PE or frozen at −20°C and subjected to compression testing and histological and scanning electron microscopy (SEM) analysis. The levels of compressive strength, stiffness (Young's modulus), and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG. PMID:24678514

Comparative biomechanical and microstructural analysis of native versus peracetic acid-ethanol treated cancellous bone graft.

Science.gov (United States)

Rauh, Juliane; Despang, Florian; Baas, Jorgen; Liebers, Cornelia; Pruss, Axel; Gelinsky, Michael; Günther, Klaus-Peter; Stiehler, Maik

2014-01-01

Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE) treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG). Forty-eight human CBG cylinders were either treated by PE or frozen at -20 °C and subjected to compression testing and histological and scanning electron microscopy (SEM) analysis. The levels of compressive strength, stiffness (Young's modulus), and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG.

Comparative Biomechanical and Microstructural Analysis of Native versus Peracetic Acid-Ethanol Treated Cancellous Bone Graft

Directory of Open Access Journals (Sweden)

Juliane Rauh

2014-01-01

Full Text Available Bone transplantation is frequently used for the treatment of large osseous defects. The availability of autologous bone grafts as the current biological gold standard is limited and there is a risk of donor site morbidity. Allogenic bone grafts are an appealing alternative, but disinfection should be considered to reduce transmission of infection disorders. Peracetic acid-ethanol (PE treatment has been proven reliable and effective for disinfection of human bone allografts. The purpose of this study was to evaluate the effects of PE treatment on the biomechanical properties and microstructure of cancellous bone grafts (CBG. Forty-eight human CBG cylinders were either treated by PE or frozen at −20°C and subjected to compression testing and histological and scanning electron microscopy (SEM analysis. The levels of compressive strength, stiffness (Young’s modulus, and fracture energy were significantly decreased upon PE treatment by 54%, 59%, and 36%, respectively. Furthermore, PE-treated CBG demonstrated a 42% increase in ultimate strain. SEM revealed a modified microstructure of CBG with an exposed collagen fiber network after PE treatment. We conclude that the observed reduced compressive strength and reduced stiffness may be beneficial during tissue remodeling thereby explaining the excellent clinical performance of PE-treated CBG.

Reconstruction of internal nasal valve, septum, dorsum, and anterior structures of the nose in a single procedure with a molded bone graft: the sail graft.

Science.gov (United States)

Guneren, Ethem; Ciftci, Mehmet; Karaaltin, Mehmet Veli; Yildiz, Kemalettin

2012-05-01

Excessive surgical removal or traumatic loss of the tissues supporting the nasal roof can result in the "saddle nose" deformity. It involves both cartilage and bone deficiencies. Two main resources are used to reconstruct this difficult deformity: autogenous bone and cartilage grafts and alloplastic materials. This study presents the reconstruction of the dorsum, septum, internal nasal valve, and anterior structures and the tip of the nose using a block of molded autogenous bone graft. We called it the "sail graft," because it looks like a sail from a lateral view. The mast of the sail is oriented in a superior-to-inferior direction, beginning in the frontonasal region to the tip of the nose to form a straight, well-rounded dorsum. The longest postoperative follow-up of 13 cases is now 10 years; the median follow-up is 2 years. The results have been satisfactory.

Contemporary guided bone regeneration therapy for unaesthetic anterior peri-implantitis case

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Benso Sulijaya

2016-12-01

Full Text Available Background: Dental implant is one of an alternative solutions reconstruction therapy for missing teeth. Complication of dental implant could occurs and leading to implant failure. In order to restore the complication, surgical treatment with guided bone regeneration (GBR is indicated. The potential use of bone substitutes is widely known to be able to regenerate the bone surrounding the implant and maintain bone volume. Purpose: The study aimed to demonstrate the effectiveness of implant-bone fully coverage by using sandwich technique of biphasic calcium phosphate (BCP and demineralized freeze-dried bone allografts (DFDBA bone substitutes combined with collagen resorbable membrane. Case: A 24-year-old male came with diagnosis of peri-implantitis on implant #11. Clinical finding indicated that implant thread was exposed on the labial aspect. Case management: After initial therapy including oral hygiene improvement performed, an operator did a contemporary GBR to correct the defect. Bone graft materials used were 40% β-tri calcium phosphate (β-TCP-60% hydroxyapatite (HA on the outer layer and DFDBA on the inner layer of the defect. Resorbable collagen membrane was used to cover the graft. Conclusion: GBR with sandwich technique could serve as one of the treatment choices for correcting an exposed anterior implant that would enhance the successful aesthetic outcome.

Assessment of rotatory instability after anterior cruciate ligament reconstruction with a bone-patellar tendon-bone graft

International Nuclear Information System (INIS)

Tashiro, Yasutaka; Okazaki, Ken; Miura, Hiromasa

2010-01-01

Anatomically oriented anterior cruciate ligament (ACL) reconstruction has been advocated recently, but its effect on rotatory instability remains to be cleared objectively. The purpose of this study was to quantitatively evaluate rotatory instability in ACL reconstructed knees with a bone-patellar tendon-bone (BTB) graft using an open MRI system. Eighteen subjects underwent arthroscopic ACL reconstruction with a BTB graft. The tibial tunnel was placed in the center of the ACL footprint. The femoral tunnel was drilled transtibially at the 10:00 to 10:30-o'clock position for the right knees. Subjects were examined using a Slocum anterolateral rotatory instability test in open MRI. Anterior tibial translation was measured at the medial and lateral compartments by evaluating sagittal images. Anterior knee stability was evaluated using the KT-2000 arthrometer. The clinical knee function was assessed with the Lysholm and Tegner scoring scales before and after the surgery. Side-to-side differences of anterolateral tibial translation was 0.1 mm. Side-to-side difference on KT-2000 arthrometer measurement was 1.8 mm. The Lysholm score improved to 96 and the latest Tegner score reached substantially the preinjury level. ACL reconstruction with a BTB graft was successful in restoring rotatory stability as well as anterior stability and knee function. (author)

BONE GRAFTING ENHANCED BY PLATELET-RICH PLASMA IN TREATMENT OF AVASCULAR NECROSIS OF FEMORAL HEAD

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A. A. Korytkin

2018-01-01

Full Text Available Treatment of avascular necrosis of the femoral head is an issue of current interest while it affects young and employable people. So far there is no well-defined strategy of management which would help to postpone hip arthroplasty and further revision procedure. Hip sparing surgical treatment of avascular necrosis of the femoral head by bone grafting prior to head collapse proved to be a viable option not only during early stages of disease but also at advanced stages. Platelet-rich plasma (PRP addition to treatment plan potentially helps improving bone regeneration in situ.In this article the authors present a case of a 37 years old patient with avascular necrosis of the femoral head at a fragmentation stage (type 4B by ARCO. The authors centrifuged 15 ml of autologous whole blood (1500 RPM obtained by a special double-contoured syringe. During the surgical stage of treatment PRP and morselized bone graft were mixed to introduce and impact into the debrided zone of avascular necrosis. The authors also introduced 0.3–0.4 ml of PRP into the debrided zone of avascular necrosis after bone grafting. At 6 months follow-up CT images of the studied patient demonstrated signs of bone reorganization and no loss of femoral head sphericity. Preoperative Visual Analogue Scale (VAS, Harris Hip Score (HHS and Hip disability and Osteoarthritis Outcome Score (HOOS prior to treatment were 60, 45 and 33 points respectively. Postoperative VAS, HHS and HOOS scores were 10, 78 and 78 respectively. In the authors’ opinion, impaction bone grafting enhanced by PRP helps obtaining good and excellent outcomes not only at early but also at advanced stages of avascular necrosis.

Morphology and Phase Transitions in Styrene-Butadiene-Styrene Triblock Copolymer Grafted with Isobutyl Substituted Polyhedral Oligomeric Silsesquioxanes (Postprint)

National Research Council Canada - National Science Library

Drazowski, Daniel B; Lee, Andre; Haddad, Timothy S

2007-01-01

Two symmetric triblock polystyrene-butadiene-polystyrene (SBS) copolymers with different styrene content were grafted with varying amounts of isobutyl-substituted polyhedral oligomeric silsesquioxane (POSS) molecules...

Morphology and Phase Transitions in Styrene-Butadiene-Styrene Triblock Copolymer Grafted with Isobutyl Substituted Polyhedral Oligomeric Silsesquioxanes (preprint)

National Research Council Canada - National Science Library

Drazkowski, Daniel B; Lee, Andre; Haddad, Timothy S

2006-01-01

Two symmetric triblock polystyrene-butadiene-polystyrene (SBS) copolymers with different styrene content were grafted with varying amounts of isobutyl-substituted polyhedral oligomeric silsesquioxane (POSS) molecules...

Vascularized fibula grafts for reconstruction of bone defects after resection of bone sarcomas

DEFF Research Database (Denmark)

Petersen, Michael Mørk; Hovgaard, Dorrit; Elberg, Jens Jørgen

2010-01-01

We evaluated the results of limb-sparing surgery and reconstruction of bone defects with vascularized fibula grafts in 8 consecutive patients (mean age at operation 13.6 years (range 4.1-24.2 years), female/male = 6/2) with bone sarcomas (BS) (osteosarcoma/Ewing's sarcoma/chondrosarcoma= 4....../3/1) operated on form 2000 to 2006. The bone defects reconstructed were proximal femoral diaphysis and epiphysis (n = 2), humeral diaphysis (n = 2), humeral proximal diaphysis and epiphysis (n = 1), femoral diaphysis (n = 1), ulnar diaphysis (n = 1), and tibial diaphysis (n = 1). One patient with Ewing......'s sarcoma had an early hip disarticulation, developed multiple metastases, and died 9 months after the operation. The remaining patients (n = 7) are all alive 50 months (range 26-75 months) after surgery. During the follow-up the following major complications were seen: 1-2 fractures (n = 4), pseudarthrosis...

THE RESULT OF INTRAMEDULLARY NAILING WITH BONE GRAFTING OF TIBIA'S PATHOLOGIC FRACTURE

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V. M. Shapovalov

2010-01-01

Full Text Available The authors give the clinical case of successful surgical treatment of patient with tibia's pathologic fracture by intramedullary nailing with bone grafting. The disadvantages of such patients' treatment by plaster immobilization and by some invasive methods like vascular autografting by Ilizarov's method and bone plating were also discussed. The obvious benefits of proposed surgical treatment technique of observed patient category are shown.

Efficacy of different bone volume expanders for augmenting lumbar fusions.

Science.gov (United States)

Epstein, Nancy E

2008-01-01

A wide variety of bone volume expanders are being used in performing posterolateral lumbar noninstrumented and instrumented lumbar fusions. This article presents a review of their efficacy based on fusion rates, complications, and outcomes. Lumbar noninstrumented and instrumented fusions frequently use laminar autografts and different bone graft expanders. This review presents the utility of multiple forms/ratios of DBMs containing allografts. It also discusses the efficacy of artificial bone graft substitutes, including HA and B-TCP. Dynamic x-ray and/or CT examinations were used to document fusion in most series. Outcomes were variously assessed using Odom's criteria or different outcome questionnaires (Oswestry Questionnaire, SF-36, Dallas Pain Questionnaire, and/or Low Back Pain Rating Scale). Performing noninstrumented and instrumented lumbar posterolateral fusions resulted in comparable fusion rates in many series. Similar outcomes were also documented based on Odom's criteria or the multiple patient-based questionnaires. However, in some studies, the addition of spinal instrumentation increased the reoperation rate, operative time, blood loss, and cost. Various forms of DBMs, applied in different ratios to autografts, effectively supplemented spinal fusions in animal models and patient series. beta-Tricalcium phosphate, which is used to augment autograft fusions addressing idiopathic scoliosis or lumbar disease, also proved to be effective. Different types of bone volume expanders, including various forms of allograft-based DBMs, and artificial bone graft substitutes (HA and B-TCP) effectively promote posterolateral lumbar noninstrumented and instrumented fusions when added to autografts.

Predictive value of ridge dimensions on autologous bone graft resorption in staged maxillary sinus augmentation surgery using Cone-Beam CT.

NARCIS (Netherlands)

Klijn, R.J.; Beucken, J.J.J.P van den; Bronkhorst, E.M.; Berge, S.J.; Meijer, G.J.; Jansen, J.B.M.J.

2012-01-01

INTRODUCTION: No studies are available that provide predictive parameters regarding the expected amount of resorption after maxillary sinus augmentation surgery using autologous bone grafts. Therefore, the aim of this study was to determine parameters influencing the outcome of the bone graft

Evaluation of the incorporation of bone grafts used in maxillofacial surgery with [{sup 18}F]fluoride ion and dynamic positron emission tomography

Energy Technology Data Exchange (ETDEWEB)

Berding, G. [Abt. fuer Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule, Hannover (Germany); Burchert, W. [Abt. fuer Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule, Hannover (Germany); Hoff, J. van den [Abt. fuer Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule, Hannover (Germany); Pytlik, C. [Klinik und Poliklink fuer Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule, Hannover (Germany); Neukam, F.W. [Klinik und Poliklink fuer Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule, Hannover (Germany); Meyer, G.J. [Abt. fuer Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule, Hannover (Germany); Gratz, K.F. [Abt. fuer Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule, Hannover (Germany); Hundeshagen, H. [Abt. fuer Nuklearmedizin und Spezielle Biophysik, Medizinische Hochschule, Hannover (Germany)

1995-10-01

This study investigates the incorporation of bone grafts used in maxillofacial surgery by means of {sup 18}F-fluoride ion and PET. It considers patients who received pedicle grafts for mandibular reconstruction or onlay grafts for alveolar ridge augmentation. Dynamic PET images and arterialized venous blood samples were obtained within a 1-h period after i.v. injection of {sup 18}F-fluoride. Assuming a three-compartment model and applying multilinear least squares fitting, bone blood flow and fluoride influx (K{sub mlf}) were determined. Additionally Patlak plot analysis was used to calculate fluoride influx (K{sub pat}). Early after surgery a significant increase in flow and influx compared to vertebral bodies was observed in the regions of osteosyntheses between grafts used for reconstruction and recipient bone. At the same time pedicle grafts showed a significant increase in flow but not in influx. Furthermore K{sub pat} was significantly lower in pedicle grafts than in onlay grafts. In follow-up studies a significant decrease in flow occurred in pedicle grafts and the regions of osteosyntheses. Moreover the latter showed a significant decrease in K{sub mlf} as well. It is concluded that {sup 18}F{sup -} PET depicted increased blood flow and osteoblastic activity in onlay grafts and regions of osteosyntheses, indicating bone repair in the graft and adjacent host bone early after surgery. For the regions of osteosyntheses the decrease in both parameters corresponded to uncomplicated healing. The lack of increased influx, although flow was increased in pedicle grafts, most likely indicates that some necrosis occurred in these grafts despite patency of anastomoses. It may be concluded that {sup 18}F{sup -} PET provides further insight into the biology of graft incorporation. (orig./MG)

BMP2-loaded hollow hydroxyapatite microspheres exhibit enhanced osteoinduction and osteogenicity in large bone defects.

Science.gov (United States)

Xiong, Long; Zeng, Jianhua; Yao, Aihua; Tu, Qiquan; Li, Jingtang; Yan, Liang; Tang, Zhiming

2015-01-01

The regeneration of large bone defects is an osteoinductive, osteoconductive, and osteogenic process that often requires a bone graft for support. Limitations associated with naturally autogenic or allogenic bone grafts have demonstrated the need for synthetic substitutes. The present study investigates the feasibility of using novel hollow hydroxyapatite microspheres as an osteoconductive matrix and a carrier for controlled local delivery of bone morphogenetic protein 2 (BMP2), a potent osteogenic inducer of bone regeneration. Hollow hydroxyapatite microspheres (100±25 μm) with a core (60±18 μm) and a mesoporous shell (180±42 m(2)/g surface area) were prepared by a glass conversion technique and loaded with recombinant human BMP2 (1 μg/mg). There was a gentle burst release of BMP2 from microspheres into the surrounding phosphate-buffered saline in vitro within the initial 48 hours, and continued at a low rate for over 40 days. In comparison with hollow hydroxyapatite microspheres without BMP2 or soluble BMP2 without a carrier, BMP2-loaded hollow hydroxyapatite microspheres had a significantly enhanced capacity to reconstitute radial bone defects in rabbit, as shown by increased serum alkaline phosphatase; quick and complete new bone formation within 12 weeks; and great biomechanical flexural strength. These results indicate that BMP2-loaded hollow hydroxyapatite microspheres could be a potential new option for bone graft substitutes in bone regeneration.

MRI appearance of femoral head osteonecrosis following core decompression and bone grafting

Energy Technology Data Exchange (ETDEWEB)

Chan, T W; Dalinka, M K; Kressel, H Y [Pennsylvania Univ. Hospital, Philadelphia, PA (USA). Dept. of Radiology; Steinberg, M E [Pennsylvania Univ. Hospital, Philadelphia, PA (USA). Dept. of Orthopedic Surgery

1991-02-01

We used magnetic resonance imaging (MRI) to evaluate retrospectively 32 hips with avascular necrosis of the femoral head before and after core decompression and bone grafting. At a median follow-up time of 15 months, 4 of 9 large lesions had undergone femoral head collapse; 2 small lesions had decreased in size; and 14 small, 6 moderate, and 5 large lesions were unchanged. One hip with biopsy-proven avascular necrosis had diffuse marrow edema which resolved after surgery. The signal pattern within the lesions was analyzed in 17 hips. MRI can demonstrate changes in size and signal characteristics as well as femoral head collapse after core decompression and bone grafting. Changes in the surrounding marrow signal, including resolution of marrow edema and reconversion from fatty to hemopoietic marrow, can also be detected. (orig./GDG).

Doped Calcium Silicate Ceramics: A New Class of Candidates for Synthetic Bone Substitutes

Science.gov (United States)

No, Young Jung; Li, Jiao Jiao; Zreiqat, Hala

2017-01-01

Doped calcium silicate ceramics (DCSCs) have recently gained immense interest as a new class of candidates for the treatment of bone defects. Although calcium phosphates and bioactive glasses have remained the mainstream of ceramic bone substitutes, their clinical use is limited by suboptimal mechanical properties. DCSCs are a class of calcium silicate ceramics which are developed through the ionic substitution of calcium ions, the incorporation of metal oxides into the base binary xCaO–ySiO2 system, or a combination of both. Due to their unique compositions and ability to release bioactive ions, DCSCs exhibit enhanced mechanical and biological properties. Such characteristics offer significant advantages over existing ceramic bone substitutes, and underline the future potential of adopting DCSCs for clinical use in bone reconstruction to produce improved outcomes. This review will discuss the effects of different dopant elements and oxides on the characteristics of DCSCs for applications in bone repair, including mechanical properties, degradation and ion release characteristics, radiopacity, and biological activity (in vitro and in vivo). Recent advances in the development of DCSCs for broader clinical applications will also be discussed, including DCSC composites, coated DCSC scaffolds and DCSC-coated metal implants. PMID:28772513

Addition of blood to a phycogenic bone substitute leads to increased in vivo vascularization

International Nuclear Information System (INIS)

Barbeck, Mike; Sader, Robert; Ghanaati, Shahram; Najman, Stevo; Stojanović, Sanja; Živković, Jelena M; Mitić, Žarko; Choukroun, Joseph; Kovačević, Predrag; James Kirkpatrick, C

2015-01-01

The present study aimed to analyze the effects of the addition of blood to the phycogenic bone substitute Algipore ® on the severity of in vivo tissue reaction. Initially, Fourier-transform infrared spectroscopy (FTIR) of the bone substitute was conducted to analyze its chemical composition. The subcutaneous implantation model in Balb/c mice was then applied for up to 30 d to analyze the tissue reactions on the basis of specialized histochemical, immunohistochemical, and histomorphometrical methods. The data of the FTIR analysis showed that the phycogenic bone substitute material is mainly composed of hydroxyapatite with some carbonate content. The in vivo analyses revealed that the addition of blood to Algipore ® had a major impact on both angiogenesis and vessel maturation. The higher vascularization seemed to be based on significantly higher numbers of multinucleated TRAP-positive cells. However, mostly macrophages and a relatively low number of multinucleated giant cells were involved in the tissue reaction to Algipore ® . The presented data show that the addition of blood to a bone substitute impacts the tissue reaction to it. In particular, the immune response and the vascularization were influenced, and these are believed to have a major impact on the regenerative potential of the process of bone tissue regeneration. (paper)

A new Fe–Mn–Si alloplastic biomaterial as bone grafting material: In vivo study

Energy Technology Data Exchange (ETDEWEB)

Fântânariu, Mircea, E-mail: mfantanariu@uaiasi.ro [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489, Iasi (Romania); Trincă, Lucia Carmen, E-mail: lctrinca@uaiasi.ro [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Horticulture, Str. Aleea M. Sadoveanu, no. 3, 700490, Iasi (Romania); Solcan, Carmen, E-mail: csolcan@yahoo.com [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489, Iasi (Romania); Trofin, Alina, E-mail: aetrofin@yahoo.com [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Horticulture, Str. Aleea M. Sadoveanu, no. 3, 700490, Iasi (Romania); Strungaru, Ştefan, E-mail: strungaru_stefan@yahoo.com [“Alexandru Ioan Cuza” University, Faculty of Biology, Bulevardul Carol I, Nr.11, 700506, Iasi (Romania); Şindilar, Eusebiu Viorel, E-mail: esindilar@uaiasi.ro [“Ion Ionescu de la Brad” University of Agricultural Sciences and Veterinary Medicine, Faculty of Veterinary Medicine, Str. Aleea M. Sadoveanu, no. 8, 700489, Iasi (Romania); Plăvan, Gabriel, E-mail: gabriel.plavan@uaic.ro [“Alexandru Ioan Cuza” University, Faculty of Biology, Bulevardul Carol I, Nr.11, 700506, Iasi (Romania); and others

2015-10-15

Highlights: • A Fe–Mn–Si alloy was obtained as alloplastic graft material for bone implants. • Fe–Mn–Si alloy degradation rate was preliminary evaluate with SEM and EDAX techniques. • Biochemical, histological, RX and CT investigations were done in rats with subcutaneous and tibiae implants. • Fe–Mn–Si alloy assured an ideal compromise between degradation and mechanical integrity during bone regeneration. - Abstract: Designing substrates having suitable mechanical properties and targeted degradation behavior is the key's development of bio-materials for medical application. In orthopedics, graft material may be used to fill bony defects or to promote bone formation in osseous defects created by trauma or surgical intervention. Incorporation of Si may increase the bioactivity of implant locally, both by enhancing interactions at the graft–host interface and by having a potential endocrine like effect on osteoblasts. A Fe–Mn–Si alloy was obtained as alloplastic graft materials for bone implants that need long recovery time period. The surface morphology of the resulted specimens was investigated using scanning electrons microscopy (VegaTescan LMH II, SE detector, 30 kV), X-ray diffractions (X’Pert equipment) or X-ray dispersive energy analyze (Bruker EDS equipment). This study objective was to evaluate in vivo the mechanisms of degradation and the effects of its implantation over the main metabolic organs. Biochemical, histological, plain X radiography and computed tomography investigations showed good compatibility of the subcutaneous implants in the rat organism. The implantation of the Fe–Mn–Si alloy, in critical size bone (tibiae) defect rat model, did not induced adverse biological reactions and provided temporary mechanical support to the affected bone area. The biodegradation products were hydroxides layers which adhered to the substrate surface. Fe–Mn–Si alloy assured the mechanical integrity in rat tibiae defects

Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review.

Science.gov (United States)

Severo, Antônio Lourenço; Lemos, Marcelo Barreto; Lech, Osvandré Luiz Canfield; Barreto Filho, Danilo; Strack, Daniel Paulo; Candido, Larissa Knapp

2017-01-01

Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria. In most cases VBGs were used, especially those based on the 1,2 intercompartmental supraretinacular artery, due to greater reproducibility in performing the surgical technique.

In vitro and in vivo bioactivity assessment of a polylactic acid/hydroxyapatite composite for bone regeneration

NARCIS (Netherlands)

Danoux, Charlene; Barbieri, D.; Yuan, Huipin; de Bruijn, Joost Dick; van Blitterswijk, Clemens; Habibovic, Pamela

2014-01-01

Synthetic bone graft substitutes based on composites consisting of a polymer and a calcium-phosphate (CaP) ceramic are developed with the aim to satisfy both mechanical and bioactivity requirements for successful bone regeneration. In the present study, we have employed extrusion to produce a

Methodological approach for the evaluation of homologous bone graft use in post-extractive atrophic alveolar ridges

Directory of Open Access Journals (Sweden)

B. Musante

2013-01-01

Full Text Available The aim of this study is to investigate the in vivo efficacy of Puros® cancellous particulate allograft bone in the regeneration of post-extractive sites. Twelve molar or premolar sites were selected. Seven days after minimally invasive tooth extraction, Puros® cancellous particulate allografts were inserted into the elected sites. TC Cone-Beam investigation and at 4 months from surgery; bone height and width were evaluated. Five months after surgery, biopsy samples of the regenerated sites were taken and histologically analyzed to qualitatively evaluate bone regeneration. TC analysis showed, a mean bone gain of 4.1 mm in height and 2.02 mm in width. The histological analysis of the samples showed intense bone metabolic activity with active osteoblasts on the implant surface, at the level of the native bone-graft interface and in the grafted area. The radiographic and histological analyses demonstrate an optimal bonen regeneration, both in terms of quality and quantity using Puros®.

Radiation sterilisation dose determination for lyophilised amnion membranes and lyophilised bone grafts

International Nuclear Information System (INIS)

Hilmy, N.; Basril, A.; Febrida, A.

1999-01-01

Radiation sterilisation of medical products is now well established in commercial scale and at present there are more than two hundred irradiation facilities in operation throughout the world. It is a cold sterilisation process without toxic chemical residues, high degree of safety and easy to control, so that it is a safe technology to sterilise human tissue grafts. According to ISO (International Organisation of Standard) No. 11137, radiation sterilisation dose should be established based on the number of product's bioburden (number of product's contaminated microbes before irradiation). Bioburden of lyophilised amnion membranes and lyophilised bone grafts produced by Batan Research Tissue Bank (BRTB) have been determined since 1990 and 1994 consecutively by using 100 up to 120 pieces of samples per year. Results show that the average bioburden of the amnion membranes were 1.4 ( 0.2 x 103; 1.2 (0.2 x 103; 1.2 ( 1.2 x 103; 4.5 ( 0.5 x 102; 1.8 ( 0.9 x 102; 2.4 ( 2.3 x 102; 1.7(l.5 x 102; 1.5 ( 1.7 x 102 cells per sample, calculated in 1990 to 1997 consecutively and the average bioburden of the bonegrafts were 1.5 (0.4x 101; 0.25 (0.12 x 101; 0; 0 cells per sample, calculated in 1994 to 1997 consecutively. Morphological of those contaminants were found to be Gram positive coccoid forms (98%) and Gram positive vegetative rod (2%) with the D10 - values of 0.25 to 0.50 kGy. No spore forming bacteria and Gram negative bacteria were found in those contaminations. The highest bioburden of lyophilised amnion membranes and lyophilised bone grafts were found to be 4900 and 80 cells per sample consecutively, and the lowest was found to be 0 cell per sample in both of materials observed. According to ISO 11137 radiation sterilisation doses for amnion membranes were ranging between 21 to 25 kGy and for bone grafts was around 15 kGy with the Sterility Assurance Level (SAL) of 106. Since 1990, radiation sterilisation dose used for lyophilised amnion membranes produced by BRTB

Allograft tolerance in pigs after fractionated lymphoid irradiation. I. Skin grafts after partial lateral irradiation and bone marrow cell grafting

International Nuclear Information System (INIS)

Vaiman, M.; Daburon, F.; Remy, J.; Villiers, P.A.; de Riberolles, C.; Lecompte, Y.; Mahouy, G.; Fradelizi, D.

1981-01-01

Experiments with pigs have been performed to establish bone marrow chimerism and skin graft tolerance between SLA genotyped animals. Recipients were conditioned by means of fractionated partial irradiation from lateral cobalt sources (partial lateral irradiation (PLI)). The head, neck, and lungs were protected with lead, the rest of the body being irradiated including the thymus, the majority of lymphoid organs with spleen, and most of the bone marrow sites

Cell response of calcium phosphate based ceramics, a bone substitute material

Directory of Open Access Journals (Sweden)

Juliana Marchi

2013-01-01

Full Text Available The aim of this study was to characterize calcium phosphate ceramics with different Ca/P ratios and evaluate cell response of these materials for use as a bone substitute. Bioceramics consisting of mixtures of hydroxyapatite (HAp and β-tricalcium phosphate (β-TCP powders in different proportions were pressed and sintered. The physical and chemical properties of these bioceramics were then characterized. Characterization of the biological properties of these materials was based on analysis of cell response using cultured fibroblasts. The number of cells attached to the samples was counted from SEM images of samples exposed to cell culture solution for different periods. These data were compared by analysis of variance (ANOVA complemented by the Tukey's test. The TCP sample had higher surface roughness and lower density. The adherence and growth of FMM1 cells on samples from all groups was studied. Even though the different calcium based ceramics exhibited properties which made them suitable as bone substitutes, those with higher levels of β-TCP revealed improved cell growth on their surfaces. These observations indicated two-phase calcium phosphate based materials with a β-TCP surface layer to be a promising bone substitute.

beta-TCP Versus Autologous Bone for Repair of Alveolar Clefts in a Goat Model.

NARCIS (Netherlands)

Ruiter, A. de; Meijer, G.J.; Dormaar, T.; Janssen, N.; Bilt, A. van der; Slootweg, P.J.; Bruijn, J. de; Rijn, L. van; Koole, R.A.

2011-01-01

Objective : The aim of this study in goats was to test the hypothesis that a novel synthetic bone substitute beta tricalcium phosphate (beta-TCP) can work as well as autologous bone harvested from the iliac crest for grafting and repair of alveolar clefts. Design : Ten adult Dutch milk goats ( Capra

Graft failure following bone marrow transplantation for severe aplastic anemia risk factors and treatment results

NARCIS (Netherlands)

Champlin, R.E.; Horowitz, M.M.; Bekkum, D.W. van; Camitta, B.M. Elfenbein, G.E.; Gale, R.P.; Gluckman, E.; Good, R.A.; Rimm, A.A. Rozman, C.; Speck, B. Bortin, M.M

1989-01-01

Graft failure was analyzed in 625 patients receiving allogeneic bone marrow transplants from HLA-identical sibling donors as treatment for severe aplastic anemia. Sixty-eight (11%) had no or only transient engraftment. Second bone marrow transplants were successful in achieving extended survival in

Biomaterial strategies for engineering implants for enhanced osseointegration and bone repair

Science.gov (United States)

Agarwal, Rachit; García, Andrés J.

2015-01-01

Bone tissue has a remarkable ability to regenerate and heal itself. However, large bone defects and complex fractures still present a significant challenge to the medical community. Current treatments center on metal implants for structural and mechanical support and auto- or allo-grafts to substitute long bone defects. Metal implants are associated with several complications such as implant loosening and infections. Bone grafts suffer from donor site morbidity, reduced bioactivity, and risk of pathogen transmission. Surgical implants can be modified to provide vital biological cues, growth factors and cells in order to improve osseointegration and repair of bone defects. Here we review strategies and technologies to engineer metal surfaces to promote osseointegration with the host tissue. We also discuss strategies for modifying implants for cell adhesion and bone growth via integrin signaling and growth factor and cytokine delivery for bone defect repair. PMID:25861724

Radiographic and Histologic Evaluation of a Bone Void that Formed After Recombinant Human Bone Morphogenetic Protein-2-Mediated Sinus Graft Augmentation: A Case Report.

Science.gov (United States)

Kang, Hyun-Joo; Jun, Choong-Man; Yun, Jeong-Ho

2016-01-01

In the present case report, the authors describe radiographic and histologic observations of a bone void that formed after a sinus augmentation using a graft material that contained recombinant human bone morphogenetic protein-2 (rhBMP-2) and discuss clinical and histologic implications of their findings. Sinus augmentation was performed using a graft material comprising 1 g of hydroxyapatite/β-tricalcium phosphate, which contained 1 mg of rhBMP-2. Radiographic evaluation was conducted with panoramic radiographs and computed tomography images of the augmented maxillary sinus, which were analyzed using a three-dimensional image-reconstruction program. Histologic evaluation was also performed on a biopsy specimen obtained 6 months after the sinus augmentation. The total augmented volume increased from 1,582.2 mm(3) immediately after the sinus augmentation to 3,344.9 mm3 at 6 months after the augmentation because of the formation of a bone void. Twenty-six months after the sinus augmentation, the bone void remained but had reduced in volume, with the total augmented volume reduced to 2,551.7 mm(3). Histologically, new bone was observed to be in contact with the grafted particles, and a fatty marrow-like tissue was present in the area of the bone void. This case report shows that the bone void that had formed after sinus augmentation resolved over time and seemed to be partially replaced with new bone. Furthermore, none of the implants failed, and clinical adverse events were not observed during the follow-up period.

Hydroxyapatite grafted carbon nanotubes and graphene nanosheets: Promising bone implant materials

Science.gov (United States)

Oyefusi, Adebola; Olanipekun, Opeyemi; Neelgund, Gururaj M.; Peterson, Deforest; Stone, Julia M.; Williams, Ebonee; Carson, Laura; Regisford, Gloria; Oki, Aderemi

2014-11-01

In the present study, hydroxyapatite (HA) was successfully grafted to carboxylated carbon nanotubes (CNTs) and graphene nanosheets. The HA grafted CNTs and HA-graphene nanosheets were characterized using FT-IR, TGA, SEM and X-ray diffraction. The HA grafted CNTs and graphene nanosheets (CNTs-HA and Gr-HA) were further used to examine the proliferation and differentiation rate of temperature-sensitive human fetal osteoblastic cell line (hFOB 1.19). Total protein assays and western blot analysis of osteocalcin expression were used as indicators of cell proliferation and differentiation. Results indicated that hFOB 1.19 cells proliferate and differentiate well in treatment media containing CNTs-HA and graphene-HA. Both CNTs-HA and graphene-HA could be promising nanomaterials for use as scaffolds in bone tissue engineering.

Partial medial second toe pulp free flap and dermal substitute with skin graft for salvage reconstruction of a complete skin envelope degloving of the small finger.

Science.gov (United States)

Calafat, V; Strugarek, C; Montoya-Faivre, D; Dap, F; Dautel, G

2018-04-04

Skin envelope degloving of fingers are rare injuries that require rapid care and surgical treatment. Mostly caused by ring finger injuries, these traumas include bone, tendon and neurovascular pedicle damage. The authors present an unusual case of finger degloving limited exclusively to the skin envelope, without skeletal, tendinous or vascular lesion. This rare case of skin envelope degloving rendered microsurgical revascularization impossible. The authors report the results at 12 months following salvage reconstruction combining a partial second toe pulp free flap for the volar side and a dermal substitute with a thin skin graft for the dorsum. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

In vivo performance of combinations of autograft, demineralized bone matrix, and tricalcium phosphate in a rabbit femoral defect model

International Nuclear Information System (INIS)

Kim, Jinku; McBride, Sean; Hollinger, Jeffrey O; Dean, David D; Sylvia, Victor L; Doll, Bruce A

2014-01-01

Large bone defects may be treated with autologous or allogeneic bone preparations. Each treatment has advantages and disadvantages; therefore, a clinically viable option for treating large (e.g., gap) bone defects may be a combination of the two. In the present study, bone repair was determined with combinations of autografts, allografts, and synthetic bone grafts using an established rabbit femoral defect model. Bilateral unicortical femoral defects were surgically prepared and treated with combinatorial bone grafts according to one of seven treatment groups. Recipient sites were retrieved at six weeks. Cellular/tissue responses and new bone formation were assessed by histology and histomorphometry. Histological analysis images indicated neither evidence of inflammatory, immune responses, tissue necrosis, nor osteolysis. Data suggested co-integration of implanted agents with host and newly formed bone. Finally, the histomorphometric data suggested that the tricalcium phosphate-based synthetic bone graft substitute allowed new bone formation that was similar to the allograft (i.e., demineralized bone matrix, DBM). (paper)

Comparative evaluation of different calcium phosphate-based bone graft granules - an in vitro study with osteoblast-like cells.

Science.gov (United States)

Bernhardt, Anne; Lode, Anja; Peters, Fabian; Gelinsky, Michael

2013-04-01

Granule-shaped calcium phosphate-based bone graft materials are often required for bone regeneration especially in implant dentistry. Two newly developed bone graft materials are Ceracell(®) , an open-celled highly porous bioceramic from β-tricalcium phosphate (β-TCP) under addition of bioglass and Osseolive(®) , an open porous glass ceramic with the general formula Ca2 KNa(PO4 )2 . The goal of this study was to characterize different modifications of the two bone graft materials in vitro in comparison to already established ceramic bone grafts Cerasorb M(®) , NanoBone(®) and BONIT Matrix(®) . Adhesion and proliferation of SaOS-2 osteoblast-like cells were evaluated quantitatively by determining DNA content and lactate dehydrogenase (LDH) activity and qualitatively by scanning electron microscopy (SEM). In addition, MTT cell-vitality staining was applied to confirm the attachment of viable cells to the different materials. Osteogenic differentiation was evaluated by measurement of alkaline phosphatase (ALP) activity as well as gene expression analysis of osteogenic markers using reverse transcriptase PCR. DNA content and LDH activity revealed good cell attachment and proliferation for Ceracell and Cerasorb M. When pre-incubated with cell-culture medium, also Osseolive showed good cell attachment and proliferation. Attachment and proliferation of osteoblast-like cells on NanoBone and BONIT Matrix was very low, even after pre-incubation with cell-culture medium. Specific ALP activity on Ceracell(®) , Osseolive (®) and Cerasorb M(®) increased with time and expression of bone-related genes ALP, osteonectin, osteopontin and bone sialoprotein II was demonstrated. Ceracell as well as Osseolive granules support proliferation and osteogenic differentiation in vitro and may be promising candidates for in vivo applications. © 2011 John Wiley & Sons A/S.

Full-Thickness Skin Grafting with De-Epithelization of the Wound Margin for Finger Defects with Bone or Tendon Exposure

Directory of Open Access Journals (Sweden)

Jun Hee Lee

2015-05-01

Full Text Available BackgroundFull-thickness skin grafts (FTSGs are generally considered unreliable for coverage of full-thickness finger defects with bone or tendon exposure, and there are few clinical reports of its use in this context. However, animal studies have shown that an FTSG can survive over an avascular area ranging up to 12 mm in diameter. In our experience, the width of the exposed bones or tendons in full-thickness finger defects is <7 mm. Therefore, we covered the bone- or tendon-exposed defects of 16 fingers of 10 patients with FTSGs.MethodsThe surgical objectives were healthy granulation tissue formation in the wound bed, marginal de-epithelization of the normal skin surrounding the defect, preservation of the subdermal plexus of the central graft, and partial excision of the dermis along the graft margin. The donor site was the mastoid for small defects and the groin for large defects.ResultsMost of the grafts (15 of 16 fingers survived without significant surgical complications and achieved satisfactory functional and aesthetic results. Minor complications included partial graft loss in one patient, a minimal extension deformity in two patients, a depression deformity in one patient, and mild hyperpigmentation in four patients.ConclusionsWe observed excellent graft survival with this method with no additional surgical injury of the normal finger, satisfactory functional and aesthetic outcomes, and no need for secondary debulking procedures. Potential disadvantages include an insufficient volume of soft tissue and graft hyperpigmentation. Therefore, FTSGs may be an option for treatment of full-thickness finger defects with bone or tendon exposure.

Handling of the bone long pseudoarthrosis with autologo structural bone graft in failure osteosynthesis